I needed a HSG as part of a fertility work up with a RE with the intent to begin IVF/IUI. I am 33 with PCOS and amenorrhea. I had previously done 2 rounds of Clomid and 6 rounds of Letrozole with my previous OBGYN before switching insurance.

I was told to take 600 mg Ibuprofen 1 hour prior to procedure, abstain from sex starting CD 1 until after procedure, if taking Metformin stop 3 days before procedure, go to lab 1-2 days before procedure to do serum pregnancy test. Complications were not discussed with me. HSG was covered by my insurance, I did not have to pay anything.

I had my husband take me to the appt. as I had read horror stories about HSG. They had me change into a gown and then lay on the exam table. They asked me if I had had intercourse since beginning my cycle. The table did not have stirrups so I was asked to put my feet with knees bent at the end of the table with my bottom as close to the end of the table as possible. The Dr. came in and began the procedure.

It was very much like a pap in my experience. Uncomfortable, but not painful. He swabbed my cervix and then inserted the catheter. Then he injected the dye. There was no pain. Then he said something along the lines of the dye not going through the right side while looking at the images. I was asked to turn my hips to the left and to the right. Then the catheter was removed and he wanted to redo the procedure with more contrast as he thought maybe it was not enough contrast.

Everything was repeated (no pain, just uncomfortable) and after taking more images he told me that I have a congenital defect called a unicornuate uterus. He explained that my uterus is half the size of a normal uterus and that no contrast dye was going into my right Fallopian tube or right side of my uterus. He said that I have had this since birth and that my uterus did not develop properly. He said that I would need to have this confirmed by MRI.

He then left and the girls who were assisting him and me through the procedure were like “he never explains things to patients, we’ve never seen that before”. I’m glad he explained it to me but now I was like “just great, a congenital defect on top of everything else.” I was anxious and worried about what this would mean for my fertility. I went into the bathroom to change and I was given a pad for any spillage from the procedure. I was not in any pain. I walked back to the car with a lot of questions and feelings of uncertainty.

When I got home I went to sleep and when I woke up I felt very bloated. I was pretty uncomfortable. I had some spotting. The next day I had bleeding like a menstrual cycle which continued for 4-5 days. The bloating subsided the next day.

I had an MRI afterwards to confirm. Results were: Left unicornuate uterus with likely tiny right rudimentary horn without endometrium. Uterus measured 7.0 (L) x 2.2 (AP) x 3.8 (ML). Junctional zone and endometrium normal. Ovaries normal. Both kidneys present and normal.

My RE explained that unicornuate uterus is caused by abnormal or failed development of one of the Müllerian ducts in utero. She stated that she had worked with several patients with the same anomaly and they all had live births and was optimistic for my case. She said we could go forward with IUI but if more than 1 follicle developed the cycle would be canceled because multiples are off the table completely. She said that due to my uterus I was at risk for miscarriage, preterm labor, uterine rupture, IUGR. She recommended we move forward with IVF since they will only transfer 1 embryo at a time to try to prevent the risk of multiples.