text: is a shg or hsg test necessary for infertility treatment? this test sounds painful both of them.  is there any other possible tests or treatments to determine why i am not getting pregant?  i have taken clomid and that was unsuccessful.  i also have pcos. any suggestions? the best way to get pregnant is to treat your pcos. those tests help to eliminate any other problems you might have (blocked tube, scar tissue in your uterus, etc). these tests are not comfortable, but they are not really that painful. it might be worth it to do them, but you could try treating the pcos the correct way and waiting to see if it works. if not, then you should probably have these tests done just to make sure there are no other problems. here's some general pcos info and the correct treatment for it:  the underlying cause of pcos is insulin resistance (ir). the best treatment for pcos is going on an insulin sensitizing drug such as metformin (1500-2550mg per day) combined with a low carb diet and exercise. there are a few important things to know:  1. many women "pass" the test for ir, but still respond positively from the metformin. no one knows exactlly why..my thought is that the test is not a sure fire way of detecting the ir.  2. you must be on a high enough dose of metformin. i've heard women complain that their bodies dont start working even though they've been on metformin for awhile. some doctors are hesitant to up the dose past 1500mg...but for some of us it takes more. i don't respond until my dose is around 2000mg a day.   3. it can take a few months on the correct dose, before your body is regulated.   4. it is important to treat your pcos even if you are not trying to get pregnant. there are higher risks for many things (high blood pressure, blood clots, diabetes, and many other things) when you have pcos, but if it is treated properly, then those risks are lowered.   i recommend seeing a reproductive endocrinologist. they know the most about pcos and any fertility treatments you may need to undergo. i also recommend visiting http://messageboards.ivillage.com/iv-bhpcos. it's a great message board where you can ask all your pcos questions. good luck.