5 Important Things about the Hysterosalpingogram Procedure

Your doctor just told you that you need to have an HSG done and you are freaking out inside because you have read horror stories about the procedure. This was my reaction anyways and maybe yours is similar….or not. Either way, I am going to break down the HSG procedure for you so it is completely clear. No sugar coating, no secrets.

What is an HSG?

An HSG is an x-ray (in conjunction with a dye) of your Uterus & Fallopian tubes to see any potential abnormalities that might be causing infertility.

What is the Purpose of an HSG?

The purpose of an HSG is to look closely at a women’s Uterus and Fallopian tubes.


An HSG will determine if there are any abnormalities in the Uterine cavity. These abnormalities may include, but are not limited to:

  • Congenital Anomalies– Abnormal Uterine Shapes, Anatomy
  • Polyps- small (usually soft) growths in the uterine cavity
  • Leiomyomas (Fibroids)- Smooth Muscle Tumor (Very Rarely turns into Cancer)
  • Synechiae (Asherman Syndrome)- Adhesions in the Uterus
  • Adenomyosis- The inner lining of the Uterus breaks through the muscle wall of the Uterus

Fallopian Tubes

An HSG can also determine whether or not one or both of your Fallopian Tubes are blocked. It will also tell you where the blockage is occurring which will determine your treatment options. The Fallopian Tubes can be blocked in any of the following areas:

  • At the end of the tube, near the Uterus (proximal blockage)
  • The entire tube (severe and rare)
  • At the end of the tube, near the ovary (distal blockage)

There are several options for treatment, but I won’t get into that here and now. Feel free to read my experience with a blocked Fallopian Tube.

What does the procedure cost?

I always hate this question because the answer varies SO much depending on your location and your insurance coverage. First, I will give you a run down of my experience. My insurance does not offer fertility coverage whatsoever unless it is coded in a way that does not associate the procedure with fertility treatment. With that being said, I honestly cannot tell you how mine was coded, but I can tell you that I paid $103.25. My assumption from this is that if you have pretty good insurance (even if you don’t have fertility coverage) then you probably will NOT be paying a lot out of pocket.

  • The cost of an HSG varies widely in the U.S. and can cost anywhere from $800-$3,000 without insurance.
  • Be sure to consult your doctor and insurance company first if you are worried about the cost.

What does the procedure look like?

Again, everyone’s experiences are different, but there’s a big chance that the procedure will not be a whole lot different from mine. They brought me back into the X-Ray room (actual picture is at the top of this post) and handed me a gown to change into. If I remember correctly, all the undergarments had to come off (including the bra). Then they had me lay down on the table in the most uncomfortable position ever. Picture this: You must lay down on the table with your bum hanging slightly off the edge while your feet are in the stirrups. You are thinking…I’ve done that at every doctor’s office. No…you haven’t. I don’t know if it was the position of the stirrups or what, but man was it uncomfortable. And to top it off, the doc was right there watching the pantless struggle . AWKWARD.

The doctor gave me a run down of the procedure and asked if I had any questions. He told me that he would narrate as he went.

First, he used the speculum to open up the lady bits. Then he began to insert the speculum. The speculum has to go into the Uterus so it will take some time for the doctor to get it there. At that point, he had the nurse pull the x-ray machine over my pelvis. Then he pushed the dye through. As he pushed it through, he displayed the x-rays that showed the fluid flowing through the Fallopian Tubes. It was a pretty neat experience.

I had mentioned in a previous post that both of my tubes were blocked, but when I went in for an HSG a couple months ago, I was pleased to learn that BOTH of my tubes were unblocked. Hooray! But we still won’t be able to get pregnant naturally unfortunately, but I won’t get into that right now.

For another perspective, check this out by very well family.

Does it hurt?

I can only give you my experience and it’s important to remember that I am just one person and I am not YOU. Your experience could be totally different than mine. Was it uncomfortable? Definitely. Did I feel like I was going to die? Not at all. It took about 5-10 minutes from start to finish.

I will tell you this though. If the doctor cannot easily navigate their way through your reproductive tract, the catheter will be inside for a longer amount of time which might increase the pain. If your tubes are blocked and the doctor tries to push the dye through to unblock them then you will also have some pain with that.

Tips & Tricks

  • You can consult your doctor on this one if you feel you need to (I didn’t), but I was nervous about the pain…I have the pain tolerance of a baby (something that has VERY low pain tolerance) so I popped 4 Ibuprofen about an hour before the procedure.
  • Take deep breaths during the procedure and let the doctor know when you are feeling pain.

You got this. You might be stressed out and losing mind over this or you might just be fine. I am here to tell you that YOU can do this. You are strong. You are not alone.

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