My hysterosalpingogram (HSG) was scheduled for the morning of October 4th. The doctor had prescribed me an antibiotic to prevent infection, which I was to start taking 24 hours before the procedure, in addition to Midol for any discomfort I may experience.
I was really, honestly SO SO SO hopeful going into the HSG. One of my best friends in the world, who struggled with infertility for a year and didn't ovulate due to severe PCOS, was able to get pregnant without assistance immediately following her HSG.
Here's how it works: I checked in to the Radiology department and was shown back to a changing area, where I put on a backwards hospital gown, tied up in some confusing way, and some SEXY thick socks. Jared waited for me in a small room right next to the changing area, and I headed into the procedure room, immediately across the hall. We were told that it shouldn't take any more than 15 minutes or so.
There was a massive x-ray machine and a table, which the nurse asked me to take a seat on while she talked me through the details of the procedure. I had already heard all about it from my friend, and I had done a bit of research online, so I thought I had a pretty good idea of what to expect. Basically, you lay down on the table, and the radiologist inserts a tube through your cervix, into your uterus. Then, he/she pushes dye through that tube and looks at how the dye spreads through your uterus and up into your fallopian tubes. Sometimes there are blockages in the tubes, preventing eggs from reaching the uterus, which can explain a lot of fertility problems. For my friend, just the act of flushing out her tubes "jumpstarted" her ovaries to produce eggs. My big unknown was the pain - I had read that it was unbearable (worse than labor), similar to menstrual cramps, and nothing. So really, I had absolutely no idea what to expect.
The radiologist came in and introduced himself, and I laid down and pulled my gown up to my chest. By the way, it's not really a whole lot of fun to be flat out naked in a room with strangers. Just saying. They positioned the x-ray so that everything was focused around my mid-section. The nurse stood at the head of the table and told me stretch my arms out above my head and grab her hands to bear down.
The tube? No problem. Like getting a pap.
The dye? Ow. Ow ow ow ow ow ow ow.
The radiologist was being encouraging...until he told me to start rolling back and forth on the table.
Um, excuse me? Nobody mentioned that I would need to move during this process. I have no idea if this pain was similar to labor, but it sure as hell wasn't like any menstrual cramps that I've ever experienced, and I've had some bad cramps. With tears rolling down my face, I somehow managed a couple of rolls from hip to hip, until the dye made it through both tubes.
The radiologist told me right then and there that my fallopian tubes looked clear, and that everything looked good. I could hardly breathe, but I think I said something along the lines of a faint, "Yay. Thank you." He also reiterated that an HSG can improve fertility in the short term, so that I may get lucky in the next three cycles or so.
He left the room, and the nurse handed me a large maxipad and helped me to the bathroom. My friend had warned me that the dye was blue, and that I would be spotting blue for the next 24 hours, but mine was clear. I did, however, have some blood, which was perfectly normal, given that it's a fairly invasive procedure. I'm pretty sure I was out of there in ten minutes.
Jared drove me home (after scolding me for not keeping the socks. What can I say? The boy likes hospital socks.), where I went to bed, beyond glad that when I had said the words "minor procedure" to the woman I report to, she insisted that I take the whole day off. I stayed on the antibiotic for about another 36 hours, ending that run a bit early because I couldn't handle the digestive issues it caused.
Three cycles came and went, and it's now April. Obviously, we didn't get lucky. But we did have an impending appointment with the fertility specialist, including analysis of all of these tests and a recommendation for moving forward. Here's hoping.
Tuesday, April 12, 2011
Thursday, April 7, 2011
Back Again
Okay, so I left off with my tale of high FSH/low AMH and a referral to see a reproductive endocrinologist (fertility specialist). We decided on a doctor at Emory, because (1) it's a great hospital, (2) he has google-able published research on hgh FSH patients, and (3) they take our insurance. Score!
Our first visit, in mid-September, was AMAZING. We spent well over an hour talking to two different doctors, both of whom were knowledgable and realistic, but also approachable. We left there with various instructions, and feeling good.
Jared was to go back for a semen analysis and bloodwork.
I was to go back between days 2-5 of my cycle for bloodwork and a vaginal ultrasound, then again right before ovulation for an hysterosalpingogram (HSG). We also made an appointment for approximately a month later to go over all of the results. Our specialist only sees patients on Thursdays - he teaches at the medical school and does research on other days.
So. I went in on day 4 to get my blood drawn and have the ultrasound. That really wasn't particularly unpleasant, except for the fact that you have to drink water and not pee beforehand. The tech was encouraging, saying that she definitely saw developing follicles, but she couldn't tell me how many. Follicles = Good, because one of those eventually (*hopefully*) turns into an ovulated egg.
As I was checking out, the assistant says, "Oh, while you're here, why don't you run downstairs to the lab to get your bloodwork out of the way?"
"Um, I thought I did that about 20 minutes ago."
"Oh, no! You have more tests to run. We just test a few things from here."
Whatev. So I went downstairs to the diagnostic lab and they called my name after about a ten minute wait. I entered the small curtained off area they directed me to, and I literally gasped out loud. There were EIGHTEEN vials on the tray.
"Those aren't all for me, right?" I asked the tech.
"Oh, yeah. They are."
Dude. I have never had that much blood taken in my life. The vials just kept coming. (And no, I don't give blood. I have a low threshold for passing out, so doctors have advised against it.) I'm not quite sure how I kept it together...or how I stayed conscious! They tested me for every. freaking. thing. under the sun.
I left there a little freaked out, but still really optimistic that our test results would come back normal - hey, maybe the tests from my ob/gyn were a glitch, right?
Our first visit, in mid-September, was AMAZING. We spent well over an hour talking to two different doctors, both of whom were knowledgable and realistic, but also approachable. We left there with various instructions, and feeling good.
Jared was to go back for a semen analysis and bloodwork.
I was to go back between days 2-5 of my cycle for bloodwork and a vaginal ultrasound, then again right before ovulation for an hysterosalpingogram (HSG). We also made an appointment for approximately a month later to go over all of the results. Our specialist only sees patients on Thursdays - he teaches at the medical school and does research on other days.
So. I went in on day 4 to get my blood drawn and have the ultrasound. That really wasn't particularly unpleasant, except for the fact that you have to drink water and not pee beforehand. The tech was encouraging, saying that she definitely saw developing follicles, but she couldn't tell me how many. Follicles = Good, because one of those eventually (*hopefully*) turns into an ovulated egg.
As I was checking out, the assistant says, "Oh, while you're here, why don't you run downstairs to the lab to get your bloodwork out of the way?"
"Um, I thought I did that about 20 minutes ago."
"Oh, no! You have more tests to run. We just test a few things from here."
Whatev. So I went downstairs to the diagnostic lab and they called my name after about a ten minute wait. I entered the small curtained off area they directed me to, and I literally gasped out loud. There were EIGHTEEN vials on the tray.
"Those aren't all for me, right?" I asked the tech.
"Oh, yeah. They are."
Dude. I have never had that much blood taken in my life. The vials just kept coming. (And no, I don't give blood. I have a low threshold for passing out, so doctors have advised against it.) I'm not quite sure how I kept it together...or how I stayed conscious! They tested me for every. freaking. thing. under the sun.
I left there a little freaked out, but still really optimistic that our test results would come back normal - hey, maybe the tests from my ob/gyn were a glitch, right?
Sunday, April 3, 2011
Helen
One of my best friends from high school is an ob/gyn in South Carolina. She has been amazing throughout this entire process - she patiently answers any and all questions that I have, and she does so as both a doctor and as a friend.
The last thing I want to do is make anyone's eyes glass over from an abundance of technical terms or an overuse of abbreviated terms without explanation. Helen has helped me manuever through the minefield of infertility, and I couldn't be more grateful to her for doing so.
In the last few months, I haven't called her. I got to see her, her husband, and their son a few months ago, and we had a great time. We didn't talk about infertility. I'm ashamed to say it's because I resent her. I resent her because she's currently pregnant with her second child.
31 and unable to conceive is a bizarre state of being. I can honestly say that I am truly happy for my friends who get pregnant and give birth to healthy babies. At the very same time, each pregnancy announcement, each gender reveal, and each birth makes me incredibly sad.
And that's why I am having a hard time calling Helen right now. I'm so excited for her. But at the same time, I'm jealous. And I hate that.
The last thing I want to do is make anyone's eyes glass over from an abundance of technical terms or an overuse of abbreviated terms without explanation. Helen has helped me manuever through the minefield of infertility, and I couldn't be more grateful to her for doing so.
In the last few months, I haven't called her. I got to see her, her husband, and their son a few months ago, and we had a great time. We didn't talk about infertility. I'm ashamed to say it's because I resent her. I resent her because she's currently pregnant with her second child.
31 and unable to conceive is a bizarre state of being. I can honestly say that I am truly happy for my friends who get pregnant and give birth to healthy babies. At the very same time, each pregnancy announcement, each gender reveal, and each birth makes me incredibly sad.
And that's why I am having a hard time calling Helen right now. I'm so excited for her. But at the same time, I'm jealous. And I hate that.
Friday, April 1, 2011
Proven.
I know, "proven" doesn't really rhyme with "Jenn." I'm still kind of undecided about how I'm going to reconcile this blog title with my post subjects. More than anything, the title came about because the words "when" and "again" rhyme with Jenn. Because that's how my life has felt for the last nineteen months. When is this going to happen? Oh, it didn't work this month? Well, let's try again. And again. You get the idea.
So, back to the story.
My ob/gyn called with my test results, and after saying hello, the first words out of her mouth were that she wanted to refer me to a reproductive endocrinologist. This phrasing of "fertility specialist" was technical enough that it didn't really sink in with me, and I didn't get upset right away. Then she started throwing numbers at me. My FSH level was 11.2 - high. My AMH level was low - 0.1.
Then she listed two REs that she recommended, and I frantically scribbled down their names and clinic/hospital affiliations. At this point, I needed some further explanation about exactly how my high/low my hormone levels were. I apologize if this is common knowledge, but it definitely wasn't to me at the time!
FSH, or Follicle Stimulating Hormone, is released by the brain early in your cycle. It tells the ovaries to produce follicles - one of which will turn into a mature egg and be released at ovulation. If your ovaries are working great on their own, or if lots of follicles are developing with no problem, then very little FSH is generated. FSH level under 7 is good. 7-10 is above average, but manageable. Above 10 is high. To put this in perspective, yes...11.2 is considered high, but it's not until FSH levels reach about 25 that you're considered menopausal or in "ovarian failure."
Then there's AMH. And I'm still not entirely clear how Anti-Mullerian Hormone does so, but apparently the number is indicative of your ovarian reserve. Healthy = 0.7 - 1.0. Under 0.7 = Not so Healthy. Under 0.3 = Low, and concerning. Yeah, mine was 0.1. That's not good. Not many labs test for AMH, and I haven't been able to find much information on the internet, either. All I know is that my number was WAY low.
As frustrated as I was with our inability to conceive, I truly believed that all tests would reveal that I was normal. So in a sense, receiving a diagnosis of the opposite was equally horrifying and a relief at the same time. I'm not going to lie - it messed with my head. Realizing that there actually was something wrong with me while trying to be rational about moving forward with our diagnosis...well, that was a new experience for me.
So, back to the story.
My ob/gyn called with my test results, and after saying hello, the first words out of her mouth were that she wanted to refer me to a reproductive endocrinologist. This phrasing of "fertility specialist" was technical enough that it didn't really sink in with me, and I didn't get upset right away. Then she started throwing numbers at me. My FSH level was 11.2 - high. My AMH level was low - 0.1.
Then she listed two REs that she recommended, and I frantically scribbled down their names and clinic/hospital affiliations. At this point, I needed some further explanation about exactly how my high/low my hormone levels were. I apologize if this is common knowledge, but it definitely wasn't to me at the time!
FSH, or Follicle Stimulating Hormone, is released by the brain early in your cycle. It tells the ovaries to produce follicles - one of which will turn into a mature egg and be released at ovulation. If your ovaries are working great on their own, or if lots of follicles are developing with no problem, then very little FSH is generated. FSH level under 7 is good. 7-10 is above average, but manageable. Above 10 is high. To put this in perspective, yes...11.2 is considered high, but it's not until FSH levels reach about 25 that you're considered menopausal or in "ovarian failure."
Then there's AMH. And I'm still not entirely clear how Anti-Mullerian Hormone does so, but apparently the number is indicative of your ovarian reserve. Healthy = 0.7 - 1.0. Under 0.7 = Not so Healthy. Under 0.3 = Low, and concerning. Yeah, mine was 0.1. That's not good. Not many labs test for AMH, and I haven't been able to find much information on the internet, either. All I know is that my number was WAY low.
As frustrated as I was with our inability to conceive, I truly believed that all tests would reveal that I was normal. So in a sense, receiving a diagnosis of the opposite was equally horrifying and a relief at the same time. I'm not going to lie - it messed with my head. Realizing that there actually was something wrong with me while trying to be rational about moving forward with our diagnosis...well, that was a new experience for me.
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