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What is the difference between a hsg and an hysteroscopy?

Imanurse03Imanurse03 member
in Miscarriage/Pregnancy Loss

We've been doing IF treatments with a RE for the past year for my PCOS.  For my initial workup, I had an hsg done last March and everything was normal.  Since then and after 3 rounds of Clomid/IUIs and 2 rounds of injectables/IUIs I've had 2 BFPs.  The 1st one ended in a b.o. and I had a d & e for that and my 2nd loss was probable ectopic and I was given mtx.  DH and I had completely normal RPL panel results. 

 I guess I'm wondering if I should ask RE if I need a repeat hsg since I've had a d & e and then an ectopic.    Or should I ask about having an hysteroscopy?  What would a hysteroscopy tell me that an hsg wouldn't?  I guess I'm just grasping at straws here but I definitely don't want to resume the IF treatments if there's some other underlying problem (that could be contributing to my m/cs) not being addressed.  I'm going to post this on TTTC board, too, but thought some of you ladies would have some insight, too.  Thanks.
 

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Re: What is the difference between a hsg and an hysteroscopy?

  • I_am_DCAI_am_DCA

    HSG and hysteroscopy look at some similar thing and some different things. 

    HSG will show if they cavity fills abnormally (septum, cornuate, didelphys) and if the tubes are patent.  It will also show if there is something wrong with the tubes (not patent, widened).

    Hysteroscopy does not evaluate the tubes at all.  It only looks into the uterine cavity.  It looks for abnormalities of the cavity.  If you have polyps, a septum or adhesions, they could be surgically removed at the time.

    Basically they look for similar things.  One is not superior over the other.  Was your HSG before or after your ectopic?  If it was truly an ectopic, you might have something wrong with your tube - and a hysteroscopy would not be able to evaluate that.

    Another option is to a hysteroscopy and a diagnostic laparoscopy with chromotubation.  But a laparoscopy is more invasive.  

    Discuss this with your REI....he/she is the only one who can really tell you what is right based on your history.  Good luck.  I am so incredibly sorry for your losses.

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  • Sue&PasqualeSue&Pasquale member

    I would suggest having both. HSG checks to see if tubes are blocked. the shape of it etc.

    They do not however always detect an uterine abnomality. Mine didnt. it also didnt see if there is scarring. I have a tipped uterus so it didnt see my uterine septum.

    I just had a hysteroscopy and that found my uterine septum and scarring. it is the gold standard in dectecting abnormalities from what I read.

    If you are doing the testing I would have them both. but talk to you re. they are pretty thorough.

    good luck

    Suzanne & Pasquale 9/9/07
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    Our Sweet boy Luca Salvatore 10/6/10 & Our precious daughter, Arianna Regina 4/9/13
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