I am on the please please please do the HSG before you do an IUI side. I had my first IUI last May (w/ clomid), got pregnant, and it turns out it was an ectopic. I almost died...was rushed to the ER with a blood pressure of less than 60/40 and had to have a transfusion. Also, read below for my answers to your concerns...
1. I'd have the HSG done in June, but I wouldn't be beginning IUI till September after I return from a trip, so I wouldn't get the "fertility burst"
I had my HSG in July, a month after my ectopic. I did not get pg during the 'fertility burst'.
2. When my DH and I visited our first fertility center (after he had cancer), they did a workup on both of us including a transvaginal ultrasound for me and the Dr. said things looked great on my end.
I had u/s's before my IUI...they do not show if your tubes are blocked or not. I don't think they can even see the structures of the tubes with just a transvag u/s...
3. Unlike many who start infertility treatments, my DH and I haven't been "trying" yet. We always knew we'd have to go with IUI due to his cancer, so I'm still in the "wouldn't it be exciting to have a baby" phase and not in the more sad/emotional phase that the friends I have from a fertility support group are in.
This is a good point, but there is an increase (it isn't huge, but it is there) in the possibility of an ectopic with IUI. I had 2 prior pregnancies (both m/c's, non-ectopic) so there was no reason to think I had a tubal issue.
4. I worry that the risks (infection, possible sensitivity to the iodine, possible scarring from the procedure, etc) don't outweigh the benefits yet. If I wasn't pregnant after two-three IUI attempts, then it would seem more worthwhile but right now there hasn't been evidence to suggest that my tubes are blocked.
I was put on an antibiotic. The risks of infection and scarring are the same as with the catheter for an IUI. The dye doesn't cause scarring/infection (it is sterile). This gets done by a professional. Iodine sensitivity, well, if you have had an issue before, then there are other tests that can be done, but if not, you shouldn't have a problem. I am allergic to shellfish, yet I have had CTs w/ contrast and the HSG and haven't had a problem.
Since I had the 2 pgs and both confirmed in my uterus, there was no evidence to suggest that my tubes were blocked either. And if you do have a slight blockage in your tubes, the dye from the HSG can push it out (clean out your tubes).
I see your point that the doctor is just being thorough in her analysis. After having a husband in the hospital with cancer, I've started to question tests before going ahead with them. His drs would order a number of tests on him that were so not necessary (including a pregnancy test, on a man, come on!!)
Okay, your DH's Dr is an idiot for ordering a pregnancy test on a man. WTF? And yes, definitely question everything. But I didn't have the knowledge of an HSG before my IUI. Yes, it is uncomfortable. I shed a couple of tears. But it was done in 5 minutes. And the pain was gone. And I think it is better to know that yes, your tubes are fine, then go on and always wonder. If your RE is suggesting the HSG because IUI or IVF is the only way you can get pregnant, wouldn't it be better to know what your tube situation is before you waste money on IUIs (if you are blocked) and possibly risk an ectopic?
Just my 2 cents. Definitely you gotta do what is best for you. Let us know what you decide to do.