March 26, 2009

More Diagnostic… HSG & Saline Ultrasound

The diagnostic included a Hysterosalpingogram (HSG: http://www.advancedfertility.com/hsg.htm) to make sure my uterus was okay and fallopian tubes were open. During a HSG, a catheter, or tube, is placed into the cervix, X-ray dye is slowly injected into the uterus which comes out through the fallopian tubes into the abdomen. The dye is radio-opaque, meaning it is detected by an X-ray. The X-rays taken during the procedure evaluates the condition of the uterus and the fallopian tube. HSG is performed between day 6 to 10 of your cycle (assuming your periods are 5 days or shorter). Abstinence is required right from the beginning of the cycle (I missed one cycle because the radiologist didn’t clearly inform me about it… so beware! Fortunately my cycle was very short that time, and I could make a quick appointment with the Radiologist again). I took Doxycycline the day before, the day of and the day after HSG (twice a day). This is an antibiotic and is used to prevent uterine infection. I was asked not to take Metformin the day of HSG. I had to fast for 3 hours before the procedure, had to take an enema to clear my bowel and had to take Tylenol to help reduce cramping/pain during the procedure. The procedure is short… I had intense cramping when the dye was introduced. Though, it disappeared right as the dye passed out of the uterus!

The HSG didn’t quite go well! The radiologist suspected that my uterus had horns… my fallopian tubes were open. I had no idea what the heck that (horn) meant! But it of course didn’t sound +ve!!! I came home confused and looked up information online… never had I known that in reality there are different kinds of uterus (Uterine Abnormalities are congenital: http://babyjava.net/main/index.php?blog=3&title=uterine_abnormalities&more=1&c=1&tb=1&pb=1) I was devastated, I just wanted to know that my uterus was alright and I could carry a baby if I were to get pregnant! Appointment with the RE was couple of weeks away! I was very nervous the day I went to meet my RE. He suspected a septum in the uterus. A septum can divide the uterus into two sections, reducing the space available for a baby to grow, thus causing a miscarriage (along with other possible heath issues for baby/mother). If there is a septum, it could be surgically removed. The procedure takes place right after the AF (when the uterine lining is minimal); recovery period is 2 months (cycles) before one can start TTC again! He wanted to confirm the presence/absence of the septum by performing a saline ultrasound (Sonohysterogram/ Hysterosonogram).

Saline ultrasound is performed right after the AF at the RE’s office. It involves infusing sterile fluid (saline solution) inside the uterus. Thus the walls of uterus separate from each other and any abnormalities that might have been hiding will be easily identified by performing a vaginal u/s. It did not seem as intense as the HSG. There was not as much prep work required and there was no cramping during the procedure. News was +ve… there was no septum, there probably is a slight indentation at the top of the uterus, but is not significant enough to be operated upon in an attempt to fix it. I was relieved… if I was going to get pregnant, my uterus was not going to be a complete disaster! We could now start with the actual treatment!

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