Hi mjank,
I am so sorry to hear of your ectopic pregnancy and loss. It is very natural to feel anxious when trying to conceive following an ectopic pregnancy. Unfortunately, I am not medically trained, so I cannot comment on your specific case, but I will do my best to help.
I have copied our information on HSG testing for your information and review:
A Hysterosalpingography (HIS-tur-oh-sal-ping-GOG-ru-fee) HSG test is a valuable test if you have been trying to conceive for a year and are not pregnant if you are under the age of 35, or six months if you are over the age of 35. You should visit your health care provider to discuss this.
(HSG) is a very safe procedure to investigate the shape of the uterine cavity and the shape and patency (the state of not being blocked or obstructed) of the fallopian tubes. The test is an x-ray of the uterus and the fallopian tubes. The doctors inject a special radiographic dye into the uterine cavity through the vagina and cervix which shows up on the x-ray. They then watch to see if the dye moves freely through the uterus and fallopian tubes to look for a block that may be causing fertility problems.
If the fallopian tubes are open, the special dye will fill the tubes and spill out into the abdominal cavity. If the fallopian tubes are full or partially blocked the dye will not flow freely and whether the blockage is located at the junction of the tube and the uterus (proximal) or whether it is at the end of the fallopian tube (distal) can also be determined. The test is not 100% accurate as the fallopian tubes can go into spasm during the test and can appear blocked even though this isn’t the case. The test can also not determine what the internal villi of the tube look like.
The HSG can be painful, so analgesics (pain relief) may be administered before and/or after the procedure to reduce pain. Many doctors will also prescribe an antibiotic, such as Azithromycin, prior to the procedure to reduce the small risk of an infection. The medical professionals prescribe the antibiotics taking the viewpoint that prevention is better than cure and it is better to prevent an infection in your fallopian tubes rather than cure it.
Many women feel emotionally conflicted between wanting the peace of mind of answers versus the fear of catching an infection that could potentially do harm when they have a HSG test.
There is only a 1% chance of getting an infection from a HSG test and, of that 1% chance of infection, only 20% of the 1% who get an infection would need hospitalisation… This means that you have a 99.8% chance of not damaging your fallopian tube and a 0.2% chance of damage.
It would be likely that you would know if you got an infection through symptoms like abnormal vaginal discharge, painful menstrual periods, painful or uncomfortable sexual intercourse, abdominal pain affecting both sides, frequent urination, spotting between periods, pain during ovulation, fever, and/or lower back pain.
People are able to try to conceive again during their next menstrual cycle after a HSG test, unless medical professionals suggest a longer wait time. It has been claimed that pregnancy rates are increased in a cycle when an HSG has been performed.
My doctor says it is too early to have a Hysterosalpingogram (HSG) test, why?
Doctors prefer not to use a HSG test unless they really need to because it is not a 100% accurate test. For example, if the fallopian tubes go into spasm during the test they can appear blocked even though this isn’t the case. The test can also not determine what the internal villi of the tube look like. Furthermore, it is an invasive test and there is a very small (1%) chance that it can cause infection of the fallopian tubes hence their preference to only perform the test when it is unquestionably required.
When an ectopic pregnancy is treated, the remaining tube is typically examined externally and the doctors would usually have told you if they had seen any problems with it at that time. If you would like peace of mind about this you could ask for a post-operative follow up appointment to ask whether they had looked at the condition of your fallopian tubes during the operation.
The examination is a pretty good indicator about the condition of your remaining tube(s) because it looks at:
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The fimbriae – The fallopian tubes are not attached to the ovaries and, at the point of ovulation, some very delicate structures called the fimbriae begin to move gently creating a slight vacuum to suck the egg toward the end of the tube it is nearest to (like lots of little fingers waving and drawing the egg towards it).
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Whether there are any adhesions (scar tissue).
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Whether there is any thickening of the tube.
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The shape of the tube.
I know that ttc brings up many conversations and decisions to make. Please take this in your own time, continue advocating for yourself and asking questions of your GP, and make sure that you are comfortable with the answers you are receiving. There is still so much unknown in the process of pregnancy and that can be frustrating, especially for those of us experiencing ectopic pregnancy.
Please be good to yourself and take things in time. We are here for you for as long as you need.
With good wishes,
Michele
The Ectopic Pregnancy Trust
Registered Charity Number: 1071811
Ectopic pregnancy patient information suite: Highly Commended in the 2019 BMA Patient Information Awards
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Detailed medical information can be found on our website. Please remember online medical information is NO SUBSTITUTE for expert medical advice from your own health care team.
