Tag Archives: fertility

Hysterosal-what?

When we first started trying to get pregnant, our nurse, who I will refer to as Nurse Knock-up, assured me that there was no reason she could see that I wouldn’t be pregnant within three months, and if it didn’t happen in three months, she’d be investigating and possibly putting me on drugs to get me preggers. Three months came and went, and in the process, she discovered some sort of cyst on my left ovary. She sent me to a specialist, who ruled it an endometrioma. He didn’t tell me this meant I had endometriosis, but he didn’t tell me that it didn’t mean that either. He suggested before inseminating another round, I get a hysterosalpinogram (HSG) to make sure my tubes weren’t blocked. I live my life on the cut of Occam’s razor, whereby the easiest explanation to a problem is usually the right one. I didn’t want to sit out an entire cycle when I didn’t feel like I had any issues. So we inseminated that cycle (#4) and didn’t get pregnant. Nurse Knock-up ordered an HSG.

Please skip the following paragraph if you are weak-stomached: An HSG is a procedure whereby they insert a very thin catheter into your uterus via your cervix and shoot contrast (dye) into the uterine cavity. Ideally, the dye flows up through the uterus and out of the fallopian tubes, thereby proving to the doctor who is taking the picture that the tubes are indeed open. If your tubes are not open, and the force of the dye does not manage to open them, IVF is your only route. IVF, at about $12,000 per cycle, is not really an option for us.

Now, my insurance would have paid 50% of the cost of this HSG. I would’ve gone to a very nice medical facility with the best equipment and some of the best doctors. The only problem was that the medical facility would have charged my insurance $3000, so my out-of-pocket would have been $1500. Nurse Knock-up “knew a guy” who could do the same procedure for $285. I had been inseminated four times at this point and had been prodded and poked in my nether-regions enough that I wasn’t at all afraid of a discount HSG. It did concern me a little that this procedure is done between day 8-10, when your cervix isn’t necessarily open for business, but I figured I could handle it.

I did a lot of research about this procedure and found that the literature compares it to a pap smear… maybe a little bit more uncomfortable. They suggest taking ibuprofen before the procedure to reduce the risk of pain. I couldn’t really understand how it would be that much differnet from my virtually painless inseminations, so I passed on the Advil and showed up sober. This was not my smartest move.

The first sign of trouble came when the Swashbuckler was not allowed in the room with me. She’d been with me for every poke and prod before, and I’d been counting on her being there for this one. Nope. Because this is essentially an x-ray, only “necessary personnel” are allowed in the room. I find her very necessary, but they didn’t agree. Once I stripped down, I was led to a very old exam room with a very, very flat table, a table you’d rent from a church for a graduation party. The “stirrups” were nothing more than knobs that were placeholders for my feet. The doctor was a young Asian guy, not the best with the English, but he seemed nice enough. I’m not sure if he was gay or very inexperienced, but he did not know his way around a vagina.

He dug around for about 15 minutes, looking for my cervix. As I mentioned before, up to this point, I’d had a lot of professionals lay eyes on my cervix. I knew it was there. I knew it wasn’t that hard to find. But this guy couldn’t find it. He finally called in for his dad, who owns the practice apparently, and who speaks less English than his son, to come in and find the pesky cervix. He looked for another 20 minutes or so and finally found it. So at this point, I’ve had a speculum inserted and pulled out and re-inserted for the past 35 minutes, and we still haven’t seen my uterus.

Finally – jackpot – the nurse insisted, “yes, that’s it!” and the doctor inserted the catheter. So far so good. Once the catheter was in place, he began to inject me with the contrast. Immediately, pain washed over me. It was not remotely gradual. It was fine, and then it wasn’t. You can imagine, that part of your body isn’t made to accept THAT much liquid, so once it’s there, your body starts contracting to push it out. It’s basically like you all of a sudden have some of the worst menstrual cramps ever and you can’t curl up, you can’t get the heating pad, you can’t pop a vicodin. You have to lay still so they can take x-rays of the very area that is screaming with dull, throbbing pain. At this point, I’m already on the verge of tears from the pain, and he’s looking at the monitor and in his very broken English, he says, “The dye is not going through your tubes. If your tubes are closed, you can’t get pregnant except a test tube baby.” I cut him off: “Yes, I know the implications. You don’t have to tell me.” Luckily for him, he kept relatively quiet after that.

He forced a little bit more dye, and had me roll from side to side, and finally, the dye pushed quickly through my left tube and spilled out into the area surrounding my baby makers. I imagine the next most beautiful sight for me, after clearly seeing my open fallopian tube, will be when I finally see my baby’s heartbeat. This was definitely a good thing. However, he was unable to see my right tube. He assured me the x-ray would give him a better idea of what was going on there, but he did say, “You only need one open tube to make a baby.” He then said, “So when you’re ready to have your second baby, make sure you come back and we’ll do this again to make sure you’re open.” On one hand, it was a relief to hear him say that he was confident I’d get pregnant… on the other hand, he still had the catheter in me and I was still in a lot of pain, so I said, “Let’s just concentrate on one baby for now, okay?” I took a vicodin as soon as I left there and spent the rest of the day in a comfortable buzz.

It was a long five days before I got the results of the test. He noted that the right tube was initially not visible, but upon further forcing of the dye, it seemed to open up. Nurse Knock-up’s reading of the report was that the doc is 99 percent sure both tubes are open (100 percent sure on the left, 99 percent sure on the right). Your chances of getting pregnant increase greatly in the 3-7 months after this test is performed. This is also good news, but the cycle immediately following this test was not successful, and we only have two tries left with our known donor. Still, I’m remaining optimistic.  Stay tuned.

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