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A meta-analysis of all published studies comparing HSG to laparoscopy with chromopertubation (another diagnostic method) demonstrated HSG to have a sensitivity of 65% in the diagnosis of tubal obstruction and a specificity of 83%.
Several studies have reported a slight increase in unassisted conception during the first few cycles following an HSG. While the exact cause is not known, it is thought that the insertion of the dye might actually "flush out" any very minor blockages, permitting normally functioning reproduction to occur.
A very slight percentage (around 1%) of women will experience an infection resulting from HSG, and of those, a very small minority are serious enough to warrant IV antibiotic therapy.
The discomfort from the procedure of HSG, as with anything, varies with the individual; however, it is reported to be at least "uncomfortable" for the majority of women. Some women experience this discomfort as extremely painful, while others do not. Most doctors usually just prescribe OTC drugs (aceteminophen and ibuprofen); some offices will allow the use of a local anesthetic injected into the cervix. In general, the discomfort is usually described as mild to severe menstrual-like cramping which may last for several hours following the procedure.
Patient Becky Ruffing described the pain of her own HSG, performed after "several months of BBT charts, Clomid, and infertility tests":
"...my local hospital apparently does not believe in stirrups, so I had to make due by placing my heels together under my butt and pushing my knees apart (if you can imagine that). The physician placed a long tube inside me and squirted the dye through my tubes. I remember thinking that it was not so bad. Then he told me to move back on the table and lie flat so they could take x-rays of my tubes. That's when I began to feel a lot of severe cramping due to pressure caused by the dye. I think I would have passed out had I not been lying down and breathing deeply. The pain only lasted for about five minutes, but it seemed a lot longer."
Becky's HSG detected extensive tubal blockages which were later more closely examined through laparoscopy. She is scheduled soon to begin the couple's first IVF procedure.
Abington Reproductive Medicine offers more on post-procedure complications and suggestions to alleviate discomfort. David Sable, M.D. covers a number of things that radiologists/physicians might do to lessen the pain. Radiologist Michael Applebaum, M.D. discusses sonohysterography, which he describes as a less painful, safer alternative to hysterography (HSG).
© Tracy Morris
