HSG

In the investigations for the infertility, I had to undergo a procedure called an HSG (Hystero-salpingogram). This procedure checks your Fallopian Tubes for blockages. It is carried out using an x-ray so there can be no chance you are pregnant for the procedure.

Because my cycles are irregular I had to give my body a false day 1. I had to take a medication called Provera for five days. This starts a chemical period, day 1 is the first day of your period. When I was referred for this test I was given a prescription for a massive dose of antibiotics to be taken straight after the HSG to avoid an infection from the dye. The pharmacist where I had the prescription made up was a little confused by it, because it's not a normal dose, but when I explained what it was for he was OK about it and just told me how to take them.

The HSG had to be carried out between days 10 and 14 of the cycle so we had to abstain from sex from day 1 until after the HSG.  As the procedure has to be done on certain days of the cycle you have to phone the department on day 1 (or if it's a weekend) the next weekday to book it in for days 10-14. So you call them and they book you in and tell you to bring your antibiotics with you.

When I went in to have the procedure, it's only as an outpatient, so I just had to go to the clinic. I got checked in and had my blood pressure checked and allergies written up and all the normal stuff. They got me to change into a gown and take off my knickers- obviously. Then I went into the x-ray room with two really nice members of staff. One was a nurse and the other is the actual x-ray/HSG tech. The nurse is basically there to keep me calm and relaxed. I had to lie down on the bed, like getting ready to have a smear test, feet together, knees out and down to the sides. They put a blanket over me to 'preserve my modesty', however, it does also keep you warm, I was there for a while with my nether regions exposed to the elements.

The tech then explained how the procedure worked. She showed me what equipment they would be using. She explained that she would be setting up a speculum just like when you have a smear test, and that she would then be feeding a flexible needle into the neck of my cervix and up into my uterus. When the needle was in the correct place, which she would monitor using x ray images of my abdomen, a dye would be injected. The x-ray would then take several images of my uterus while the dye moved up through my Fallopian Tubes, into my ovaries and then out into the abdominal cavity. She explained that it would take about 10 minutes and would be uncomfortable, and I might feel some cramping during the procedure and I may feel a little faint afterwards when they remove the needle and the speculum.

Whenever a medical professional is about to insert an uncomfortable medical implement into your nether regions they always seem to tell you to relax. Relax is not something which is easy to do at this point in time. But the nurse is there, chatting away to me and generally distracting me from down there. Once the speculum is in place it isn't too uncomfortable, certainly not painful, just odd. The needle going in also doesn't feel painful, it's more a pushing sensation as you don't really have nerve endings on your cervix. At this point, I get all interested in the actual procedure, because the pain/discomfort bit is mostly done, I can concentrate on what the technician is saying from in between my knees. She told me that she was injecting the dye and that I might feel some pressure, then she sort of sat back and waited. She explained that the dye will naturally move up into my tubes and then through my ovaries and out. She took the x-rays using a big x-ray machine positioned right above my belly (which is counter-intuitive as I'd always thought you should avoid too many x-rays for your reproductive health but anyway) and then she just said, right we're all done I'm going to take the needle out now you may feel some cramping and discomfort. So she pulled that out and it did sting a little bit. Then she, very gently, unclipped the speculum and removed it. They seem to have developed a little 'tilt and twist' move when they take them out and it avoids the dreaded fanny fart. I was told to stay lying down for a little while longer, they covered me below the waist in the blanket and said that I could see the images if I wanted to. As a total nerd, I of course wanted to see them. There was a screen next to me, so they put the images up on them and flicked through. The technician showed me the shape of my uterus (the right shape for a uterus - I was very relieved to hear), she pointed out the dye going up my Fallopian Tubes (both clear, no blockages) and then 'blooming' around my ovaries. The right ovary was totally free flowing, the dye dispersing out into my abdominal cavity, the left was a little slower and the technician said that it was nothing to worry about, that it may have been some maturing follicles (the little sack the egg matures in) on that ovary.

Once I'd had a few minutes to readjust to how my insides felt, I was allowed to sit up, slowly. As I didn't faint at this point, I was allowed to get changed back into my normal clothes. I was given some baby wipes and a really nasty bulky hospital sanitary pad. The procedure can cause some bleeding and some of the dye can come back out that way rather than all going into the abdominal cavity, so it's better to have some protection as the dye is disgusting. I'd been advised of this when I'd booked the procedure so I'd taken some of the pads I prefer to use, instead of the awful hospital one. As it happened, I didn't bleed and there was only a tiny bit of the dye that came out. It was kind of greasy and oily, but it wasn't as horrific as I thought it might be.

When I was clean and dressed I went back into the waiting room part and was met by my lovely nurse. She gave me some squash and some biscuits to take the antibiotics with. I'm pretty sure horse tranquilisers are smaller than one of the tablets I had to take. That made me feel more sick than the entire procedure had. After the nurse was happy I had taken the antibiotics and wasn't going to faint or be sick she sent me home.

I was a little tender - I suppose I'd been stretched a little bit more than normal - and had some sharp cramps for the rest of the day but mainly I was fine.

The results went back to the fertility clinic and we waited for our next appointment.

Infertility Journey So Far Timeline

This is the timeline of my fertility/infertility journey. I might do more in depth posts about particular aspects of it, but I think for me, organising it all into the timeline gives a fuller picture of how we've got to the point we're at now.

My periods started when I was about 12 and were irregular (as they often are for the first few years) For a little while, I had a period every three weeks, then I would have no period for several months. I wasn't sexually active so there was no chance I was pregnant. Physically my body was developing at a similar rate to my peers.

At around 17, I started taking the contraceptive pill as I had a long term boyfriend and we were sleeping together. The pill regulated my cycle and dealt with the PMT cramps and mood fluctuations I was getting (which were really unpredictable because my cycle was so unpredictable). The pill did make me gain weight and my blood pressure went up so after a while I was advised to switch contraceptive methods and I went for the contraceptive implant. This pretty much suppressed my periods completely which wasn't a problem at the time. I didn't lose the weight I'd gained, but I didn't gain much more.

That's the background, I did have irregular cycles which may have been a signal I would have trouble conceiving but it was put down to standard teenage irregularity and then was masked by the contraception I was taking.

So, here is the actual fertility bit:

2009 - married to Husband #1 and trying for a baby having had the contraceptive implant removed but no menstrual period since removal. As an aside, husband #1 had told me that he had experienced health issues in childhood which may have affected his fertility - at this point it could have been a combination of factors in both of us which were preventing us from getting pregnant, ie I might not be the problem. 

2010 - still no period or pregnancy but I experienced a depressive episode and we decided it wasn't the right time to continue trying so I got an implant put in again while I worked on my recovery.

2011 - the marriage broke down and we divorced. I had STI checks done and everything was clear.

2011-2013 - Not trying for a baby at this time, practicing safe sex and had the implant removed to allow my cycle to return to my version of normal and give my body a break from the contraceptives.

end of 2013: engaged to the man who will become Husband #2 (aka THE ONE) and not using contraception. No regular or predictable cycle and no pregnancy. At this point it becomes apparent that it is me that is the problem. We went to the GP and were referred to the fertility clinic towards the end of the year. We go to clinic, have blood tests, semen analysis and an HSG (Hystero-salpingogram). Results all come back fine so we are given Clomifene to try for 6 months. We decide to wait until Feb 2014 to start the Clomifene to give me the chance to reduce my anti-depressants and so that if I did fall pregnant on the first cycle, I would be 12 weeks by our wedding and the dress, which I had already bought, would still fit. I experienced another depressive episode over that Christmas.

2014: With medical advice we decided not to continue trying to have a baby for the time being. Again, I needed to work on my recovery.

2015: After lots of support from my amazing GP, the psychiatry team at out-patients, sorting out my medication and joining a therapy group, we decided my recovery was going very well. In the summer we were referred back to fertility clinic. After reviewing our details, the fertility clinic were happy for us to begin the Clomifene with a day 21 blood test in cycles 2 and 3.

2016: Back to fertility clinic after still not falling pregnant with Clomifene. We were referred for IVF.

So that pretty much brings us up to date. We've been to the GP to sign the eligibility confirmation forms for the IVF referral (stating that we don't have any children already, that we don't smoke, that any resulting child will be well cared for etc) and had some blood tests done just to cover all the bases. The blood results will be back by Monday, then our GP will send the form to the consultant, he will fill in his set of test results and then send it on to the IVF clinic.

The consultant and the GP feel that we do have a very good chance with IVF. The consultant said around a 60% chance of success and my FSH levels are good. This really is our best chance to have a baby of our own. We just have to wait for the IVF clinic to contact us now.