HSG help following ectopic

[Magicstar2025]

Been ttc for a year now since an ectopic pregnancy losing my tube. GP referring us to fertility clinic. I am concerned there could be damage to my remaining tube and wanted to look into going private for a HSG or similar for peace of mind. Wondering if anyone has experienced this and can shed some light?

1. If I go private will there be additional costs like blood tests, follow up appointments etc / hidden costs?

1. Would NHS be able to accept the results from the private clinic?

1. Those who have had an ectopic or fertility tests has NHS offered a HSG as part of the investigations?

Thank you x

Hi there I have been in your exact position. I'm very sorry for your loss and know how traumatic all this is.

I was offered a HSG on the NHS but in reality after many months of ringing to book and them not having space it wasn't actually possible so I went private. I didn't have anything else done privately (at that time), just the HSG.

It cost me £600 I believe, nothing hidden. Happy to PM and give you details if you tell me roughly where in the country you are. I already had the antibiotics as I got the prescription for them from the NHS, you'd have to pay for that privately if you don't already have a script for them.

As soon as I went private I rang the day my cycle began and got booked in for my CD15. With the NHS every time I rang on my CD1 I was told no appointments for that cycle. It was really frustrating and I don't regret going private.

My remaining tube came back clear however in two years of TTC I have never had a pregnancy from that tube - only from the now removed one. We are now doing IVF. It was not a waste though, and if anything, had it come back blocked id have simply moved to IVF sooner.

Also yes, they will accept the results. I've chosen to do my IVF private, but I sent the HSG results to my NHS consultant prior to her giving us our NHS referral for IVF. So if we had stuck with that route, it would have been fine. It was only after we met with the IVF clinic we decided to go private with a multi cycle deal rather than take the NHS funding.

@MocktailMe thank you so much for your reply that's really helpful, so sorry you have been through the same, its such a hard thing to go through. Given that it took nearly 2 months for my husband to get booked in for a sperm appointment before being referred makes me think private may be the route to go down. Every month that passes feels like wasted time. My cycles are irregular too can range from 33 - 39 days, I didn't realise you had to have the HSG at a certain time of the month so that may prove tricky to get an appointment with NHS anyway as my ovulation day varies. Did you have the HSG done with the same clinic you are having IVF with? I am based in the south in Surrey. That's exactly how I feel at the moment, if it comes back blocked my answer is made for me and we can move forward and look into IVF x

No I did not, im with a totally different place for IVF.

You call on the first day of your period and book in then - they aim for it to be mid-cycle but it doesn't have to be bang on ovulation day or anything. It's just important to abstain from sex from CD1 until the HSG. I ovulated CD17 and had my HSG CD15.

The issue I was having with the NHS was ringing every cycle on CD1 and being told again and again sorry can't get you in this cycle, call back next time on the first day of your period. It was ridiculous.

Where I went would easily be 3 hours travel from you - I dont want to disclose my location on here, but I'm up north. I'm sure you will find somewhere local but if you want I'm happy to message you where it was.

If you go to an IVF clinic I assume you'd have to pay for a consultation as well. Where I went that wasn't necessary - it was a private fertility investigative clinic within an NHS setting.

So I was in a similar place….i did eventually get a HSG on the NHS

What I would say is that the test can only show if your tube is blocked or not - it cannot say whether it is damaged or not or works or not. Not all ectopics are caused by blocked tubes. In my case it was scar tissue. The HSG showed my tube was clear and “looked normal” ….i still went on to have another ruptured ectopic and lost my last tube. There is no known test to confirm if the tube actually works and if the tiny hair like structures inside it can move an egg into the right place

This is the conclusion my consultant came to...there's no visible damage (seen during my salpingectomy) and the HSG was clear, but she reckons the tiny hair like structures aren't working. But two years TTC speaks for itself..the only pregnancies I've had were through my now removed tube. I know it's not my partner his sperm is excellent. So something is wrong.

Despite that I'm still glad I did the HSG. It's a journey, and at that time I wasn't ready to accept IVF. Getting the clear result allowed me to carry on TTC for a while until I decided I was ready to move to IVF. Getting a blocked result would have been the jumpstart I needed to accept that route. It was worth the money for me for that even though physically it didn't help me.

Sorry you've been through that. I've had 2 ectopics and wasn't offered a HSG on the NHS. Waited 9 months for a fertility appointment and all they did were blood tests. The services that are offered seemed to really vary depending on what area you live in. If you can afford it I think private is definitely the best option for fertility issues.

Hi,
just wanted to add my experience as saw you are in Surrey. I went to Surrey park clinic for Hycosy (similar to HSG but ultrasound) and would recommend. I did this outside of any ivf pathway as had only been ttc 3 months before ectopic, had the Hycosy 6 months later.

I had a consultant appointment first (booked a week or so in advance) which was £260 then HSG was £600. Consultant talked the hsg results through with me at the time so I didn’t need to pay for another follow up.

My consultant appt happened to be beginning of my cycle and I booked Hycosy 2 weeks later. Message directly if you want any more info :)

I wouldn’t pay for the hsg privately … if you are able and willing I would just make onto IVF. Bear in mind though that ivf actually increases the risk of an ectopic rather than decreases it if your tube doesn’t work though (which I found to my cost) I did go on to have success with IVF eventually though x

IVF doesn't always increase risk of IVF for an individual.

There is a higher risk of ectopic with IVF for the general population. However, after multiple ectopics you are already at elevated risk - much higher than the general population. So the IVF ectopic risk is actually lower for me than natural conception.

For someone with no risk factors IVF is a higher risk and it's something you should discuss with your doctor to find out your personal risk.

I'm very sorry to hear of your ectopic and can only imagine how devastating it must have been off the back of IVF.

Sorry to jump on this thread and sorry to read you’re going through this. My first fertility appt with the NHS is in 2 weeks, my plan was to ask for a hycosy/investigations and then start IVF in January. I had a ruptured ectopic a year ago and lost my left tube and have been TTC for 2 years now. Reading some of these comments I didn’t realise how difficult it might be to get a hycosy on the NHS or that they might not offer me one at all! I’m wondering if I should just not put too much hope on the NHS appt and concentrate on IVF in January. My partner has 1% sperm morphology and i’ve had 2 previous csections so have no idea if we’ll ever conceive naturally again. My biggest worry is damage to my remaining tube and scar tissue - I think unless I had a laparoscopy they wouldn’t really be able to tell for sure!

I'm not sure, but given you have already had children I doubt you'd be offered one. I only was as was told it was a lre-requisite to IVF (which I am eligible for on the NHS, I'm just choosing private). Wheras you wouldn't be eligible, so might have to pay for investigations privately? I'm genuinely not sure though.

Probably best to go for IVF after an ectopic, every time the ovulation is on the bad side it may be wasted., particularly if you are getting older. I ended up having two ectopics, the fist one really scary. The other one was an IVF pregnancy. Whichever make sure you are very carefully monitored and remember an ectopic can happen before you realise you are pregnant with bleeding like a (possibly mild) period and can become pretty dangerous very quickly.

@MocktailMe after my salpingectomy the consultant said the same that tube looked normal (they said they put dye down it) but as no sign of a positive test since I am convinced something is wrong with the tube! That's the perspective I am thinking at the moment for peace of mind, if tube is okay continue to ttc whilst we navigate what to do next re NHS / private route. Did you have the HCG after your salpingectomy? X

@autumnevenings25 thank you for your reply, I thought a HSG would show everything including any damage or scarring so that's good to know given they think my tube looked fine in surgery. Its horrible not knowing and second guessing everything! So sorry you went through the same. Amazing that IVF worked for you gives me hope! x

@SunsetIceCream so sorry to hear you had two ectopics. That's my worry exactly the length of time, we've waited months for my Husband's initial sperm test appointment before they will refer us to the specialist and the GP can't tell me how long the wait will be from there just that she doesn't think it is too long🫠 have you gone private now? x

@Percy15 thank you so much for your reply! So sorry to hear you went through an ectopic too. I will have a look into this for sure. Did they recommend Hycosy over a HCG or are they the same thing? x

@BadgernTheGarden thank you for your reply and so sorry to hear you have had two ectopics. I feel every month I am on high alert incase it happens again. Apparently the remaining tube moves to catch the egg from the tubeless side but not sure this is guaranteed x

Thank you for your reply and so sorry to hear you had a ruptured ectopic, its so scary. Hope your fertility appointment goes well, if you remember keep us updated as to wether they offer you a Hycosy! Surely if you ask for one they cant say no especially as youve had an ectopic. How long did you wait for the NHS fertility appointment?

Thank you xx I think they only do hycosy there and as far as I’m aware it’s quite similar but ultrasound instead of xray so no radiation. She also checked my follicle count and uterine lining.

just to say I was told by that consultant as well about remaining tube catching egg from the other ovary and to keep trying rather than go straight to ivf (though I had no other risk factors/known issues) I had actually ovulated from the other side to the tube my ectopic was in xx

@SWeal since you have children already and aren’t eligible for IVF on the NHS I would just crack on with the IVF appointment - the clinic won’t really be bothered what the results of the scan show x

Thank you for your replies everyone - it’s so helpful. I always like to be realistic about things, so it’s good to know others experiences. We’ve always said we’d start IVF in the new year so I’ll see what the NHS fertility nurse says but won’t hold out much hope!

@Magicstar2025 I’ll definitely update you and let you know if they offer me one. My partners first fertility test took forever to organise and they wouldn’t refer me until he’d had the results. I think i’ve probably waited around 4 months since being referred. My partners having his second sperm analysis in 2 weeks too as he had 1% sperm morphology on the last one so hoping this has improved with life style changes. I think IVF is just our best option now anyway - just financially it’s so difficult xx

I’ve just been looking info IVF clinics in London/Kent - and oh my god, it is a minefield 🫠 How do you know where is good and where isn’t?! And the prices are so different. Does more expensive mean better chances of success? I’ve registered for a webinar with 1 clinic but my brain is already fried just from looking around online! 😵‍💫

Look at the success rates for your age bracket to help you choose. Then factor in distance - you have to visit a hell of a lot, so make sure it's somewhere you can reliably get to.

Some offer packages through Access Fertility and other finance programmes, so if that interests you check their partner clinics.

Then read the reviews. I like reading Google reviews as they are easy for people to post so you tend to get a full picture, more so than the curated 'our stories' you'll find on the clinic website.

I imagine near London you are absolutely flooded for choice - I only had about three I could reasonably get to (within 2 hours driving) so it wasn't as hard to narrow it down.

You can also ask at your fertility appointment is there a clinic they recommend.

@Magicstar2025 Just an update - I had my fertility appt on Monday. It went better than I expected really, they want to wait for my partners 2nd sperm analysis results before deciding next steps, she said they’d definitely offer an HSG if they come back normal range but if they’re still 1% morphology it would have to be referred to a consultant to decide - which doesn’t mean it won’t be offered but it’s not routine. Essentially it won’t be ‘unexplained’ infertility as my partners sperm isn’t what it should be. However she did say that his sperm figures aren’t terrible and we still should be able to conceive naturally. It was just incredibly unlucky that the 1 time a ‘good’ sperm got through and managed to fertilise the egg, my body didn’t implant it in the right place causing an ectopic. I actually left feeling quite positive to be honest, she also said they’d consider clomid/letrozole.

Also @MocktailMe thank you for your advice re IVF clinics. I’ve had some webinars/calls with some. Some are charging £11k and some are £4k which seems insane, esp when their success rates are about 2% difference. Definitely need to do more research into it but feel better having more knowledge!