IVF Babble

What’s the Likelihood of Getting Pregnant After HSG?

By Jennifer Jay Palumbo

I’ve had two HSG’s, and that was enough. I remember my doctor telling me, “This may be uncomfortable.” But, of course, my doctor at the time was male, and I’m pretty sure that if he had a uterus and fallopian tubes, he’d have used a stronger word than “uncomfortable.”

Both times I had this test done, one person or another told me, “Some women get pregnant after an HSG! It cleans everything out!” So while a hysterosalpingogram isn’t Roto-Rooter, some connection may help clean out the pipes!

HSG, or hysterosalpingogram, is an imaging technique that assesses the general uterine shape and checks if the fallopian tubes are clear. The procedure can also be used for “tubal flushing” (that paints a lovely picture, doesn’t it?), which is a therapeutic procedure to help clear the fallopian tubes. Below, we delve into HSG (more like OMG, this sucks!) and why it can help some become pregnant.

How Does HSG Work?

HSG is an x-ray procedure that involves placing iodine dye into the uterus (I hoped for a baby but got iodine… whoopee) and fallopian tubes via the cervix. The dye is carried in a water or oil-based contrast medium. This allows the doctor to take an x-ray image to assess whether or not there is a blockage in the fallopian tubes.

Is Getting Pregnant After HSG More Likely?

If you Google HSG, you’re likely to come across many women who claim that they became pregnant after undergoing the procedure. Furthermore, some doctors agree that there are benefits. However – interestingly – the likelihood of getting pregnant after HSG seems to have a relationship to the contrast medium.

More than 1000 women under the age of 39 with unexplained infertility have HSG with either water-based or oil-based liquids in a recent study,. Later, the researchers found that women administered the oil-based contrast medium were more likely to have conceived. In addition, the study found that 38% of women who had undergone HSG with the oil-based medium had a live birth, compared to 28% of the water-based group.

Why Might HSG Increase My Chances of Getting Pregnant?

Although the study mentioned above found that more women got pregnant after tubal flushing (again… what a phrase!) with an oil-based medium, they can’t say why. Go figure.

However, there are some theories, the first being fairly obvious. Many specialists suspect that the dye and medium flush out the fallopian tubes, clearing minor blockages. In this instance, if the doctor performs an x-ray, the results will show clear fallopian tubes. I should add, though, that tubal flushing (I’ll never get used to that term) can’t clear significant blockages. In short, HSG’s are not Drano.

A second theory is that the dye enhances the endometrium, encouraging embryo implantation. Equally, some specialists think that the dye solution might somehow stimulate the ovaries, promoting better ovulation. Furthermore, some doctors believe that placing the catheter into the cervix inadvertently performs endometrial scratching, boosting pregnancy rates in some women.

Another fun little tidbit is achieving pregnancy after HSG is more likely for those with unexplained infertility issues. So far, research has shown there is unlikely to be benefits for those with underlying physiological problems such as endometriosis. Remember, your fertility specialist will advise you on the procedures and medications most appropriate to your individual needs.

To learn more and find out if you need an HSG and whether it could potentially help you conceive, please get in touch with a reproductive endocrinologist (and not a plumber.)

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