What is hysterosalpingography (HSG)?

HSG is a diagnostic tool that checks the patency of your fallopian tubes. It involves injecting a contrast agent into your uterus and taking X-rays to see if the dye flows through your tubes.

How long does the procedure take?

The procedure itself takes about 15-30 minutes, but you should plan to spend at least an hour at the clinic.

The procedure can be painful, especially if you're not prepared for it. You may feel a sharp cramp or a stinging sensation during the procedure.

What are the risks associated with HSG?

There's a small risk of complications, such as infection or allergic reactions. However, these risks are rare and usually mild.

How long does it take to get the results?

The results are usually available within a few days, which can give you and your partner a better understanding of your fertility prospects.

Is HSG covered by insurance?

The procedure may not be covered by your insurance, depending on your provider and policy. It's best to check with your insurance company before scheduling the procedure.

What should I expect during the procedure?

You'll lie on an X-ray table and a doctor will insert a catheter into your cervix. The contrast agent will be injected, and X-rays will be taken to see if the dye flows through your tubes.

My Two HSG Attempts: What Went Wrong the First Time, and What I Learned for the Second

Hello everyone, I'm sharing my experience with hysterosalpingography (HSG) from start to finish.

Background

After getting married in April 2022, my husband and I didn't immediately start planning a family due to some housing issues. By spring 2024, we revisited the idea, and since we weren't getting pregnant, I found a good gynecologist.

During the diagnostic process, I underwent many tests – both lab and instrumental. The doctor didn't find any issues, but suggested I check the patency of my fallopian tubes.

This led me to the story of my unsuccessful first procedure.

Attempt #1

In March 2025, I decided to go ahead with HSG. Not all clinics in my city offer this procedure, and the one my gynecologist works at can't perform it either. So, she gave me the number of her colleague at another clinic.

The ideal time for the procedure is between the 7th and 9th days of the menstrual cycle. The main indications are unexplained infertility.

The clinic I went to is affiliated with a regional hospital. I guess that's because private organizations often struggle to get the necessary equipment and infrastructure, like X-ray machines and other medical gear.

When I scheduled the appointment, I was told to get a general blood test and a cervical smear beforehand. If there are signs of inflammation, they won't perform the procedure. I got the tests done at a private lab.

Remember, no matter where you get your tests done, the cervical smear usually takes three days to prepare, while the blood test results are available by the evening.

As I entered the clinic, I found out that the doctor I was scheduled with was on sick leave, and I'd have to see another doctor instead. I was disappointed, but it didn't change my mind about going through with the procedure.

The doctor I saw briefly looked at my test results and then led me to the X-ray room. Unfortunately, I had to wait a while there because another patient was being treated in the same room.

HSG is always stressful, but this time it was doubly so. The old equipment, worn-out linoleum, and those ancient wooden doors... It turned out the worst was yet to come.

To perform the procedure, you need to lie on your back, bend your knees, and bring your feet towards your buttocks. It's not a big deal if you can hold that position for a few seconds or minutes, but try lying like that for 30 minutes, especially with your feet slipping out of the stirrups!

The procedure

To check the patency of the fallopian tubes, you need to visualize them using X-rays. But how do you do that? The uterus is a hollow organ, not a bone.

That's why they use X-ray contrast agents containing iodine, which are injected into the uterine cavity in an amount of around 10 ml.

So, the gynecologist first inserts a speculum into the vagina and then uses forceps to grasp and lift the cervix, opening its os.

I'll be honest, the procedure was a real challenge. It started off rocky, with the doctor struggling to insert the catheter. It took around 20 minutes, and even then, the radiologist couldn't get a clear view of the contrast.

The problems started early on.

I started feeling queasy around 10 minutes in. It's normal, apparently, due to the sensitive receptors in the cervix area. The procedure can trigger a strong response in the brain, leading to nausea.

Don't make the same mistake I did – bring some sick bags with you!

By the 40-minute mark, I was done. It was excruciatingly painful, and I knew something was off. I got up and saw a pile of bloody gauze pads in the tray – it was clear they'd been digging around in there.

After a quick trip to the bathroom, I was ready to call it quits. If you're going through this, take some strong painkillers beforehand.

Take two...

Three months later, I realized I needed to go through it all again. This time, I found a new doctor and clinic through my gynecologist. The specialist was a bit of a mystery – she communicated mostly through WhatsApp and didn't say much to patients. But I was determined to get the right care.

The tests were more comprehensive this time around – I had to do a blood test, a cervical smear, a urine analysis, and a micro-reaction test. I liked that I could schedule the procedure whenever I wanted, without being tied to a specific day in my cycle.

The clinic's instructions were clear – bring a spare pair of shoes and a sanitary pad.

The morning of the procedure, the doctor messaged me to send over the test results and payment confirmation. I did as she asked, and also told her about my iodine allergy.

I was bracing myself for another long, painful ordeal. But...it was all over in 40 seconds.

When it was done, the doctor showed me the results on the screen – my fallopian tubes were clear. But there was some bad news – I had a mild adhesional process. If there are adhesions, you might need to consider a laparoscopic surgery to remove them. Each case is different, so it's best to discuss it with your doctor.

As I was leaving, they told me to take it easy for three days, avoid sex, and not plan a pregnancy for a month. They also warned me that my period might come earlier than usual.

How I Felt for a Few Hours After the Procedure

I tried to take public transport home, but I regretted it. The nausea was so bad that I had to get off at the next stop.

Don't plan anything important on the day of the exam. Your condition will get worse due to vomiting and diarrhea.

The Verdict

The procedure is really unpleasant and painful, but it's worth it if it helps figure out if there's a tubal factor to infertility.

The cost is pretty low – it's 25,000 tenge (around 5,000 rubles). So, it's not a huge hit to your wallet.

Some women get the procedure not just for diagnostic purposes, but to boost their chances of getting pregnant. It's possible because the contrast they inject under pressure can clear out any small adhesions that might be blocking the way. And yeah, some people do get pregnant soon after the procedure.

The key is to find a qualified specialist and a clinic with modern equipment. That way, you'll avoid any misdiagnoses and can get everything done in one go.