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The Ink Test

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Julia Childless: Here's the latest test in my tale of trying to get pregnant.

woman at gynecologist

For many women trying to figure out why they're not getting pregnant, one of the first fertility tests doctors order is the hysterosalpingogram, or HSG (or as I like to call it, "the ink test").  Basically what they do is shoot ink up your vagina and take a bunch of x-rays of your uterus to find out whether your tubes are blocked. Sounds simple enough.

During my yearlong journey of trying to conceive, the ink test came up a number of times. I kept putting it off, because I wanted to try other, less-invasive methods first (sperm count; a Day 3 FSH test) -- but mainly because my insurance wouldn't cover it. And because I'm a little bit squeamish about medical procedures in general (I've never been to a hospital before -- for anything).

But the time had finally come: We had exhausted the other possibilities and needed to find out what was going on with these tubes of mine. Thanks to birth-control pills, my 118-day cycle had ended, and I scheduled the ink test for Day 7 of my new cycle. I had heard from a few friends that it was more uncomfortable than painful, and upon Googling the procedure, I found most message boards echoing that sentiment.

You can easily look up the step-by-step medical process, but I was just concerned with how it felt -- both physically and emotionally. Here's how the experience was for me:

Day 1: I had to get a blood test taken to prove I wasn't pregnant. Considering that I'm on the pill and my period ended the day before (and I haven't been able to get pregnant in 18 months), I already knew the answer. But the radiology department at the hospital that was performing the HSG wanted it, so I got it done.

Day 2: I start taking an antibiotic that my reproductive endocrinologist prescribed. Apparently this is to ward off any possible infection. It comes with all sorts of rules -- "Don't eat for two hours before or after"; "Don't take within two hours of ingesting anything with calcium/iron/magnesium" ....

Day 3 (Test Day): I wake up early and take my antibiotic at 6:30 AM, worried that my 8:30 breakfast and prenatal vitamins will interfere with their potency somehow. I fall back asleep and wake up totally nauseous from the pills. The last thing I want to do is eat breakfast, but I'm told I need to take two to three ibuprofen 1.5 hours before the HSG, so I force down some food.

At the hospital, I spend most of my time waiting. While there, I happen to bump into a friend -- whose wife just delivered their baby! I take this as a wonderful sign, and acknowledge that this process is going to be nothing compared to what she has just gone through. When I'm finally admitted, I'm told to strip from the waist down and put on a gown. It feels weird wearing a sweatshirt underneath, but I do as I'm told and keep my socks on, too. The nurse explains what's going to happen: They're going to insert a speculum (the duck lips the gyno uses for a Pap smear), then a catheter (ouch?!), then the ink. (That's when I may or may not feel cramping -- it varies from woman to woman.) Then they'll take x-rays.

The doctor enters. He looks like the lead in a CBS sitcom and has the same last name as my camp boyfriend. I find this all oddly comforting. He explains the procedure to me again; I'm too nervous to tell him I already know.

There are no stirrups, so I've got to utilize my leg muscles and get into a weird lying/squat position while he sterilizes the area -- puts down some clean towels; wipes my vagina with some cold stuff -- then it's a lot like a Pap smear. A really, really, really, really, really, really long Pap smear. I was grateful he didn't narrate what was happening -- I didn't need to hear the story a third time. I just felt all kinds of "stuff" going on.

Honestly, it felt like they just kept shoving things in and out of my vagina. Each time I felt something, I thought, "That wasn't too bad." And then realized it wasn't over yet. I started doing my Ujjayi breathing that I learned in yoga -- I guess I was being kind of loud, because they kept asking how I was doing and if I was OK. I closed my eyes, and "She'll Be Coming 'Round the Mountain" kept playing over and over in my head.

Then I feel it. Intense, like a really bad menstrual cramp. It lasts for a minute or two, then subsides (or maybe my breathing is working). I'm told to slide my body up so they can start taking the x-rays, and position myself in a few different angles for the uterus paparazzi. By this time, it's stopped hurting and I'm surprised that the catheter is still in.

And then it's all over! I'm asked to stay lying down for a few moments, and given a pad because I'll probably experience some bleeding and discharge. I hardly need it, though -- there's only some light spotting, and I'm not bleeding blue ink (as I imagined I would be). By the time I've gotten changed I feel back to normal -- and when I get home, I'm fine to take my dog for a walk.

So it's just like they say -- more uncomfortable than painful. The worst of it is having to take those antibiotics for another day, waiting to hear the results -- and getting the bill.

next: Kentucky Derby In All Its Glory!
7 comments so far | Post a comment now
Kristin May 1, 2010, 2:34 PM

Thank you for sharing your story! I hope you get good news. Good luck!

Anon May 1, 2010, 3:11 PM

Try 14 hours of labor and then pushing out baby with no pain medication. That’s painful.

FoxyMommy May 1, 2010, 3:32 PM

okay this procedure was more than a little “uncomfortable” for me. although my radiologist may have inserted enough ink to 10,000 bic pens, because that’s how it felt! i cramped severely for hours afterward, but had friends that easily recovered after 30 min or so with the ibuprophen. needless to say, that wasn’t close to being the end of things being probed and people eyeballing the girlie parts. IVF was a total shocker, no shame after that!!

Anonymous May 1, 2010, 4:11 PM

It hurt a lot, I’m a wimp though!

denay May 2, 2010, 1:47 PM

i threw up and passed out on the street outside the hospital after my HSG- waiting 3 minutes for my husband to get the car. ended up in the ER, I was fine, but i tell women to take it easy afterwards.

i’m not the fainting type either.

I did not get a catheter, or have the antibiotics, or the ibuprofen beforehand. Weird.

waste of time in the end, totally clear and the FSH test taken two weeks before was the simplest painless test that gave me my answer, early onset menopause. (at 33) wish it had been offered to me three years before when i told my dr. i was having issues. I was patted on the shoulder and told to ‘relax’.

good news? i’m pregnant now! from donated FET :-) due in Aug.

denay May 2, 2010, 1:50 PM

and to respond to anon (comment #2)

that’s a crappy thing to say to any woman who is having difficulty getting pregnant. I am certain - from experience- that she’d give just about anything to be able to go thru 28 hours of natural labor if she had the choice.

few things make me angrier than those who’ve had it easy telling those of us that had it hard to ‘just wait, you just wait, it’s so hard, you don’t know what you are wishing for’ we are JUST waiting. IT’S ALL WE DO!

F you.

Mila May 3, 2010, 4:51 AM

Yay denay! You took the words right out of my mouth!

The funniest thing about my HSG was when the doctor told me “now I’m going to inflate a balloon…” What! Is there a party in my vagina?! I couldn’t help but laugh and it did seem to calm me down for the rest of the procedure. Results came back, no blockage but I found out that I have an intraverted uterus. Shouldn’t be the reason I’m not getting pregnant but it has been 4 months and no luck yet. We’ll just keep waiting for the chance to be “in labor for 14 hours trying to push out a baby with no medication”

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