Choosing between HSG and Ultrasound for Diagnosing Fertility Issues?

[Anonymous]

Sadly I don’t have too much flexibility to take multiple doctors appointments

If I have to choose between an HSG at a radiologist and an ultrasound at my OBGyn which is a better use of my time to figure out which fertility issues I might have if any?

What does an HSG test for and identify that an ultrasound cannot (aside from blocked tubes)?

Is there any situation where an ultrasound might actually be superior to HSG in diagnosing issues?

[Anonymous]

Ultrasound can see things like afc (which relates to how many eggs you can produce). Hsg can see if anything is blocked. To be honest, I would never use an obgyn to diagnose Infertility. They know so little. In fact, I have to explain infertility treatment to my obs and I've used many of them. My first ob misdiagnosed me with pcos when I had none of the symptoms because she did bloodwork during my lH surge. I would go to an re. They can do all the testing in 2 appointments (blood work and ultrasound on day 3) and hsg a week later and will actually know how to interpret it. Only doing a hsg or us will not help give you a clear picture of what is going on

[Anonymous]

Anonymous wrote:Ultrasound can see things like afc (which relates to how many eggs you can produce). Hsg can see if anything is blocked. To be honest, I would never use an obgyn to diagnose Infertility. They know so little. In fact, I have to explain infertility treatment to my obs and I've used many of them. My first ob misdiagnosed me with pcos when I had none of the symptoms because she did bloodwork during my lH surge. I would go to an re. They can do all the testing in 2 appointments (blood work and ultrasound on day 3) and hsg a week later and will actually know how to interpret it. Only doing a hsg or us will not help give you a clear picture of what is going on

All of this. Try to see an RE if you can.
It has been several years since I had the HSG done, but, if I remember correctly, the HSG may also be able to identify some uterine abnormalities, as well (as can an ultrasound). But both the US and the HSG, along with day 3 bloodwork, are the typical standards for diagnosing causes of infertility. One test alone may not provide you with enough info. Also, don't forget a semen analysis for your partner, if that applies.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Ultrasound can see things like afc (which relates to how many eggs you can produce). Hsg can see if anything is blocked. To be honest, I would never use an obgyn to diagnose Infertility. They know so little. In fact, I have to explain infertility treatment to my obs and I've used many of them. My first ob misdiagnosed me with pcos when I had none of the symptoms because she did bloodwork during my lH surge. I would go to an re. They can do all the testing in 2 appointments (blood work and ultrasound on day 3) and hsg a week later and will actually know how to interpret it. Only doing a hsg or us will not help give you a clear picture of what is going on

All of this. Try to see an RE if you can.
It has been several years since I had the HSG done, but, if I remember correctly, the HSG may also be able to identify some uterine abnormalities, as well (as can an ultrasound). But both the US and the HSG, along with day 3 bloodwork, are the typical standards for diagnosing causes of infertility. One test alone may not provide you with enough info. Also, don't forget a semen analysis for your partner, if that applies.

PP here with additional info...
Also, not to be a downer, but don't disount the fact that some people do have multiple issues. So, assume you do an ultrasound and bloodwork and find you have PCOS. That doesn't rule out a tube issue, as well. You could think you have the answers from one test and start throwing money at treatments only to find that another issue is lurking around undiagnosed.

[Anonymous]

They look at different issues, so it's not really a choice. If you go to an RE, you'll have to do both as part of the initial workup

[Anonymous]

When you say you do not have flexibility to take multiple appointments, do you mean time, money or both? Sonograms and bloodwork to determine the status of your ovarian reserve can be done very early in the morning (e.g., 7h30 am). You can probably schedule a consultation with your doctor by telephone if you don't have the time to come in for an appointment. There is probably less flexibility for the HSG, but the exam itself does not take long and if there is no blockage, you get the result on the spot.

[Anonymous]

You cannot diagnose potential fertility issues by picking and choosing diagnostic tests. They each show very different things. As many have already pointed out, bloodwork gives hormonal picture, ultrasound provides follicle info and uterine info (shape, potential polyps, fibroids, etc.), HSGs check for blockages and can also confirm polyps, etc. It is a whole shebang of tests. Even without infertility treatment coverage, most insurance covers diagnostic testing. The testing does not take long and is easy to schedule if a priority to you.

[Anonymous]

you have to do both, really - the HSG will see if your tubes are clear and you don't have any uterine anomalies. the u/s will check your antral follicle count, uterine thickness and fibroids. if you do a saline sonogram (like an ultrasound), they can check your uterus for polyps and scarring.

[Anonymous]

You need to do both and I second all the PPs who say go to an RE. If time is an issue, don't waste it with an OB. And if scheduling the diagnostics is this difficult, you should think about what you might do if you find out you will need IVF to get pregnant...because that's pretty time intensive too.