Who is Reading Your HSG?

Let’s say your HSG is performed in the proper way. What about the interpretation? The results of your HSG may have a big impact on your course of therapy. If it’s normal, but someone says the tubes are abnormal, you may be pushed into surgery or directly to IVF. If your tube or tubes are really blocked and the report says they are open, you will waste months or years trying intercourse or insemination with no hope for a pregnancy. And as we said in the last blog, the jury is out on what people are saying about the uterus. Is it really possible that the readings could be so off? You bet it is. It happens every day, many times per day. I see it over and over again.
Your infertility doctor needs to look at the films directly. When my patients bring in their films for me to review, the first thing they say is, “the report is in there too”. I say thank you and look at the report, but the report is mostly useless. It’s the films that I want to see.
Now to be fair, there are a few radiology groups who do an excellent job with both the films and the reports. Most, however, do not have the experience to write an accurate report. They may have experience in doing the x ray, but because they are not surgeons, it’s hard for them to relate the x-ray to what’s really going on inside.
So, make sure your fertility doctor looks at your films, not just the report. If you are concerned about the interpretation of your HSG, get a second opinion.
I will get to the accuracy of a hysteroscopy. Thanks for reading and see post 5/17/06.

References:

  • Steinkeler JA, Woodfield CA, Lazarus E, Hillstrom MM. Female infertility: a systematic approach to radiologic imaging and diagnosis. Radiographics. 2009 Sep-Oct; 29(5):1353-70.
  • Ayida G, Chamberlain P, Barlow D, Kennedy S. Uterine cavity assessment prior to in vitro fertilization: comparison of transvaginal scanning, saline contrast hysterosonography and hysteroscopy. Ultrasound Obstet Gynecol. 1997 Jul; 10(1):59-62.
  • Swart P, Mol BW, van der Veen F, van Beurden M, Redekop WK, Bossuyt PM. The accuracy of hysterosalpingography in the diagnosis of tubal pathology: a meta-analysis. Fertil Steril. 1995 Sep; 64(3):486-91.

5 responses to “Who is Reading Your HSG?”

  1. Anonymous says:

    Good to know about having your RE or OB/GYN review the films. I’ve had 5 HSG’s and only once was the procedure performed by a Radiologist and not by my RE or OB/GYN. In that case, my OB/GYN was sent a report, but didn’t ask to see the films. I had some concerns so I called my RE who asked me to bring the films in for him to have a quick look. He scheduled me for another HSG to try to unblock my tubes using valium – didn’t work. Anyway, thanks for posting. Wondering if you could post about recommendation on having an HSG if you’ve had a c-section and are having problems conceiving again.

  2. Anonymous says:

    Is it normal for the radiologist to ask to turn from side to side during the HSG? What about take some additional films on the “way out”?

  3. Anonymous says:

    The sum total of my HSG report contained 2 very short paragraphs and said “The uterine cavity is normal. There was filling of a normal-appearing right fallopian tube. With gentle constant syringe pressure, contrast was ultimately noted in the peritoneal cavity on the right. The left fallopian tube was not demonstrated. The patient tolerated the procedure and left in good condition.” That’s it! That’s ALL the report says! Nothing more than he told me in person after he provided me more pain than I’ve ever experienced in my memory with his “gentle” pressure. He told me the reason it hurt so badly (I was screaming) was because that’s the only way the dye would make it through my right tube. He also showed me the computer screen that showed absolutely nothing resembling a left tube – ie, “not demonstrated.” It’s as if I didn’t even have a left one. A pretty sad visual. You can bet I’ve already gotten a copy of the film and will be having my RE look at it with his own eyes! There’s nothing in that report I haven’t already been able to tell me RE’s nurse (except maybe that I “tolerated” the procedure! ha.) It’s the reason I went to an RE in the first place: I trust them more than I trust a regular OB/Gyn…I’m sure going to trust him more than I trust the Radiology doctor!

  4. HSG is a great application because it helps to many doctors and students to do in a better way their work.

  5. sildenafil says:

    Well I’m not a doctor but it’s always like internet, for example if I’m looking for something I look 10 results the say the same about something.

Leave a Reply