Fertility Tests: HSG

I was so excited and nervous to get my HSG test done since it would confirm if I had a unicornuate uterus, as well as whether my fallopian tubes were open. I’d done a little research about what the test entailed in the days leading up to it and expected it to be pretty breezy. My doctor had me take a short three-day course of antibiotics, beginning the day prior to my HSG, as there is a slight risk for infection (I can’t imagine why – it’s not like they were going to be shoving a catheter and some iodine-based dye up through my cervix and into my uterus or anything. Oh, wait…)

The day of my HSG was the same day as the epic Denver snowstorm of 2016, so I was dreading my 3:30 PM appointment. I was pleasantly surprised to get a call that morning asking if I could come in at 11:30 AM instead since the snow was unrelenting and supposed to continue all day. Yes, I would be MORE than happy to come in early, thank you very much! My fertility clinic has an HSG room at their main location which made it super fast and efficient. The x-ray tech had me undress from the waist down, wrap a paper cloth around my waist and get positioned beneath a C-arm x-ray machine. The doctor doing the test could not have been nicer, and he explained to me that the procedure would go as follows:

  • For starters, he would explain what he was doing every step of the way so I wasn’t caught off guard.
  • He told me to take deep, even breaths, much like you do in yoga, in order to help the uterus relax. There was some potential for the uterus to contract and cause cramping, but I was told that since my menstrual cycle cramps weren’t severe that he didn’t expect this procedure would be either.
  • He would start by inserting a very thin catheter up through my cervix and into the uterus. 
  • Once inside, he would inflate a small balloon so as he pushed in the dye it would be forced into the uterus as opposed to running out through the cervix. 
  • He would then inject a syringe full of radiopaque iodine-based dye up through the catheter. 
  • As the dye floods the uterus, the x-ray tech would take continuous images as the dye filled the cavity and fallopian tubes. We would confirm that the tubes were open if the dye spilled out of their distal ends. 

So we begin. I could feel a slight poking sensation as the doctor worked the catheter up through my cervix. This isn’t so bad, I thought to myself. After a few seconds of poking around, the doctor (God bless his sweet bedside manner) pleasantly told me that inserting the catheter was proving to be a little tricky today. I told him that I understood that my uterus deviated significantly to the left, to which he affirmed, “oh yes it does!” Fun times. After a second unsuccessful attempt to get the catheter into my uterus he said we were going to try something a little different. He removed the catheter and proceeded to spray a numbing solution onto my cervix. I don’t think it did a damn thing. His third attempt to insert the catheter was more forceful. It was uncomfortable enough to make me wince but it was there and gone in an instant. Unfortunately, after that things got really uncomfortable. The doctor announced that he would now inflate the balloon. Ready. The second he started to inflate the balloon my uterus freaked out, as in, I started having violet contractions. I shoved my hands under my backside to prevent myself from involuntarily smacking the doctor in the face out of sheer pain, and I loudly announced to the room that “alright, now this REALLY hurts!” Bear in mind that all of this happened in the span of maybe 20 seconds, during which time the balloon fell out of my uterus and he had to inflate it a second time. Contraction central. He asked if I’d be able to handle the pain for one minute. “Yes, for sure,” I said…I mean, I don’t think I had a choice anyways. I was at least going to be confident. “Take deep, slow breaths,” he reminded me. I was trying to focus so hard on breathing that I’m pretty sure I sounded like Darth Vader. Just a few breaths later I heard “Ok, we’re done!” Excellent. 

The doctor helped me sit up and apologized that it was more uncomfortable that expected, but, he was pretty sure he knew why. The HSG confirmed that I do, in fact, have a unicornuate uterus. (Read: half a uterus= not a ton of room in there= more pain.) I was honestly surprised…I’d seriously convinced myself that my uterus was normal since my fertility consultation suggested that it might just deviate to the left. Regardless, the good news was that the fallopian tube on my good left side was totally open. 

Now that we know I have a uterine anomaly there are more tests to be done and answers to be found. Next I’ll need an MRI in order to see what the right side of the uterus looks like. Is it a true rudimentary horn with no endometrial lining, or is it a non-communicating horn with a functioning endometrium? If it’s the latter, I’ll need to have the right side laparoscopically removed for my own health and safety (because transperitoneal migration could result in a pregnancy in that horn which could cause the uterus to rupture). Lovely. Since we’re now in our eleventh cycle of TTC without success, I’m thinking that my right side is probably completely non-functioning, which would conceivably make life easier because instead of having to undergo surgery we could proceed directly to some procedures that could help us get pregnant. 

Here’s to continued prayers and patience…

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