Here’s how to prepare for the HSG

The HSG. For so many people and couples it’s a stepping stone to fertility treatment. It’s also a common first step after you’re diagnosed as infertile or exploring your fertility after a loss.

So, you’re facing that heartache and then you get this little poke. Yes, unless you have secondary infertility or assistance to conceive and birth a previous child, this can be an introduction to the world of discomfort that comes with the fertility journey, whether you get pregnant right after the HSG or after infertility treatment. Pokes happen now! I have so much compassion for you because I know these physical unpleasant sensations can make the emotional pain deepen. You’re not alone.

What is the HSG?

HSG = Hysterosalpingography

What is it, really?

In plain language, an x-ray to check your uterus and tubes. Even more specifically, it’s a procedure where a radiologist inserts a tube in vaginally and pumps (safe) dye through your fallopian tubes. You’ll be in stirrups like a Pap test, maybe in a hospital gown. There’ll probably be a nurse by your side while a radiologist does the procedure.

Is it painful?

Everyone is different. Some yes, some no, some in between. Plan for the worst, hope for the best. Read on to learn how to decrease the discomfort.

What do I do to prepare?

Above all else, follow the advice of your healthcare provider — whether it’s your fertility clinic, the place you get the HSG, or whichever medical team it is, follow their directions. They will probably suggest you take a pain reliever like Tylenol 30 min beforehand.

What can really help is relaxing techniques, putting your attention elsewhere and by not clenching or tensing your body. If they offer something to hold tightly, I recommend not to (because that’s not a medical decision). Instead, try 1 or both of these techniques. You’ll want to practice this before the HSG:

1. Meditate. Focus on your breath going in and out. Notice how shallow or deep your breath is going in and out. No need to change it, just notice that. Feel free to count each in breath and each breath out—e.g. Breath in, one. Breath out two. Breath in 3. Breath out 4 — until a count of 10. Then start from 1 and do that again. Keep completely focussed on your breath. 100% focussed until the HSG adventure is done.
2. Remember a fantastic memory. Decide ahead of time which memory or memories you’ll use. Then go over it in your head in detail. For me it’s picturing the first time I used a stand up paddle board and paddled down a narrow inlet on Salt Spring Island, watching the jellyfish and fish pass me, as I paddled and laughed with my sister. Maybe for you it’s a trip you took, or your wedding day, or a swim in a lake on a sunny summer day or a BBQ with pals or a big birthday celebration. Whatever it is, try and remember it in detail and go through that memory moment by moment and remember how it felt. Mmmmm.

If you can, bring a small maxi pad to wear after. You might not need it, but the dye might drip out. Fun!

Leave anything expensive or sentimental at home. That includes the clothes you wear, jewellery, keys, your diamond crusted tiara (I tease), or anything like that.

The radiologist / technician might tell you results right away, or they may wait for your own doctor to share.

Are there benefits to the HSG?

Yes! There can be if your tubes aren’t blocked and depending on your fertility situation. It can sometimes lead you to being more fertile for the 3 months after your HSG because your tubes are less blocked. Think of it as a clean-out of your tubes and giving sperm a more easy ride down to your beautiful egg. This is not the case or at least less likely if you have male factor infertility.

Should I do anything afterwards?

Like any procedure, celebrate that you took the time to take this step on your fertility journey. Maybe it’s having a soda stream bevy with a pump of hibiscus syrup and an umbrella tucked on top. Or perhaps it’s buying that (formaldehyde-free) nail polish you’d been considering.  Or perhaps it’s taking 2 minutes to put your hand to your heart and say thank you to yourself. Woot woot, you did it!

Whatever it is, even if it’s something really small, celebrate each step on your fertility journey.