HSG?

So after my mini breakdown over my whole TTC journey from yesterday, I decided to call my Dr. again. I spoke with my midwife from my OB's office. V and I discussed a few things about my infertility. She listened to me answered my questions and they told me she would consult with Dr. M. and then call me back. After their meeting of the minds V called me and said she thought I was ovulating. Here is why:

• My fertility charts look good. I have a clear thermal shift that coincides with cervical fluid and also cervical position.
• I have typical hormonal changes that are indicated by sore breasts, skin breakouts, headaches, moodiness and cravings. In other words all those PMS symptoms actually indicate that your hormones ARE working! LOL!
• My period arrives on time based on my thermal shift and charts. I have had a "regular"period for the past 5 months.

So I asked V if I could be gearing up to ovulate and not actually be releasing an egg. She said No because if I did not release the egg my period would be late or not arrive at all. So regular period that occur after a thermal shift in my chart indicates that I am ovulating.

I also asked her about the Metformin and whether it was true that it takes 6-8 months for the medication to regulate your cycles to help promote a pregnancy. She felt that in some women this was true, but in my case we have my charts that show my cycles are regular and I am Ovulating. It seems that the benefits of the Metformin have already happened.

The next step was to look at Tim. I won't go into details, but everything with him checks out fine. Lots of perfect forward moving swimmers! LOL!

So Dr M. and V said that if sperm is OK, egg is being released then something is preventing them from meeting up. This could be 2 things:

• Intercourse is not being timing appropriately.

Or

• Something inside of my uterus or fallopian tubes is blocking the passageway for sperm to swim up to meet egg.

Tim & I feel that our timing has been appropriate. We have had intercourse 1 to 2 days leading up to ovulation including the day of ovulation. This timing has been pretty consistent for the past few months and we are still not pregnant. I agree that timing is a huge issue when trying to get pregnant, which is why in large part I chart my cycles to pinpoint when I am at my peak fertility.

Dr. M and V agree that our timing is probably NOT the problem considering I have charted before and gotten pregnant 5 other times (2 miscarriages) using the same methods and timing. Which brings us back to an HSG or hysterosalpingogram.

Here is what webmd.com had to say about an HSG:

A hysterosalpingogram (HSG) is an x-ray test that looks at the inside of the
uterus and fallopian tubes and the area around them. It often is done for women who are having a hard time becoming pregnant (infertile).

During a hysterosalpingogram, a dye (contrast material) is put through a thin tube that is put through the vagina and into the uterus. Because the uterus and the fallopian tubes are hooked together, the dye will flow into the fallopian tubes. Pictures are taken using a steady beam of X-ray as the dye passes through the uterus and fallopian tubes.
The pictures can show problems such as an injury or abnormal structure of the
uterus or fallopian tubes, or a blockage that would prevent an
egg moving through a fallopian tube to the uterus. A blockage also could prevent sperm from moving into a fallopian tube and joining (fertilizing) an egg. A
hysterosalpingogram also may find problems on the inside of the uterus that
prevent a fertilized egg from attaching (implanting) to the uterine
wall.

The most common reason a fallopian tube is blocked is a previous surgery that causes scarring. I have never had any previous surgeries on my uterus or fallopian tubes . This risk factor does not apply to me. There is also the possibility that the fallopian tubes are not blocked structurally, but blocked with fluid/mucous that prevents the sperm from swimming through to reach the egg. Sometimes the act of just pushing the dye through the tube during the HSG will basically roto root the fluid blockage out of the way allowing passage of sperm to met egg. So even if I do not have a blockage that is seen on the x-ray, the HSG itself may be the treatment we need to successfully conceive a child.

The reason we have opted not to have the procedure done before now is honestly the money. An HSG is not covered by Insurance. The HSG is considered elective because infertility is not life threatening condition. Our local hospital charges $900 to $1200 to have the procedure done and it must be paid up front. And of course with 3 kids at home and living on Tim's income we just don't have that kind of money lying around. Nor would we put ourselves in debt to have the procedure done considering the state of the economy and our own financial position.

When I brought this issue up to V she suggested I shop around for pricing on the procedure. Our local hospital apparently is one of the most expensive places to have the procedure done and has the most limited payment plans. V said that once I find a hospital or radiologist that is willing to do the procedure and we have the fund to pay for it, she will order the test where ever it works best for us. She is even willing to leave the notes in my chart and order the test up to 6 months from now without me having to be seen by her again! These concessions she offered us are huge!

I have a friend who has had an HSG done in Sandpoint. She said that the HSG is less expensive at the hospital there by about half. So I will be calling around to the outlining area hospitals to check pricing and payment plans. If payment plans are not an option we will probably just have to wait until March when we get our tax return back. Then we could pay for it all at once.

The only other issue is that the HSG might be the end of the road for us with our TTC journey. If there is a blockage that is structural, the options for treatment leading to conception are limited and very expensive. And most options are outside of what we would agree to anyway considering we are trying to conceive our 4th child.

I have some work to do within my self before I commit to the HSG. I need to be prepared for the possibility that it may end our journey, before I undergo the HSG. If you think about us, send up some thoughts and prayers for guidance and peace making this decision. Thanks!