HSG Test for Fertility: Understanding Accuracy, Pain & Cost

Question
I am 45,have 3 children and had TR recently and would like to know what you think about the HSG test? I am wanting to have it done to see if my tubes are blocked but have heard it's not accurate and sometimes painful.Insurance doesn't cover it but I found a Radiology center that will perform the test for 168.00 cash.I know my age is a big factor here but all other tests show I'm ok.And still ovulating.Any info would be appreciated.
                   Chris Goetz

Answer
If you have had tubal reconstruction, and are trying to conceive, it may be prudent to have a HSG in order to assess patency of the fallopian tubes. As long as you are, indeed, ovulating, you can conceive. However, if you had reconstruction, there is a higher risk of ectopic pregnancy so it would be good to know if your tubes are open. The test is very accurate and shows "fill and spill" when the dye is introduced into the uterus and through the tubes. However, it does cause some pain (especially if there is a blockage) as the dye is beiing forced through the tube. Make sure that it is done by a competent technician, no matter what the cost is.