Wednesday, June 10, 2009

New Plan... and yes, I've learned my lesson... edited/updated

We had a review with our RE, Dr. Eyebrows, today. Here's the rundown.

Cysts: He thinks it's just bad luck that I've had two in a row. The cyst is currently 1.5 cm and looking pretty deflated, so it should be gone soon.

Past cycles: Dr. Eyebrows is of the opinion that IUI should generally work within three cycles. Since that hasn't been the case, he wants to investigate further.


We're going to do a sonohystogram. I'd prided myself on avoiding one of these, quite frankly, but he's concerned that there may have been some low grade infection during or after Kali's birth that may have mangled my tubes. So... we're doing a sono. How bad is it? Be honest...

If my tubes are perfectly clear, we'll do another IUI with injectables only (no Femara). We'll reassess our approach on a cycle-by-cycle basis.

If my tubes aren't clear, we'll just go on to IVF. Mr. December asked about our chances. If we transfer 2 embryos, our chances are about 50% in a given cycle. If I want to do a single embryo transfer, we'd take it to blast (5 days) and then transfer - the success rate of that is about 40%. If we transfer two embryos, our chance of conceiving twins is 30%. Mr. December favors transferring 2. I do not. We'll need an arbitrator, if we get that far.

And now... what lesson did I learn?

I'll admit it... I have been known to take my child to the fertility clinic. I do have a sweatshirt that says "[name of clinic] baby" on it, and I do keep her pretty quiet, but I'm guilty of taking her there. Sometimes it's just not possible to get child care at 7 a.m.

Anyhow, this time the waiting room was empty (big sigh of relief), we had books, a ball, and a sippy cup of juice, and everything was ok... for the first 15 minutes. But Dr. Eyebrows kept us waiting 45 minutes, and by that point Kali was exhausted and cranky. She proceeded to scream for the duration of our review appointment. Both Mr. December and I had questions, so neither of us could leave with her. It was awful. Kali will not be accompanying me to the clinic again unless one of us is under heavy sedation (can you guess which? I think you'll be pleasantly surprised!).

So that's it, in a nutshell. Apparently I'm more infertile than I thought. Damn.

ETA: Yes, we're talking about a SHG, aka saline test, not the dye test or HSG. I specifically asked about the difference, and Dr. Eyebrows told me the SHG would give him enough info. I'm pretty sure that's not the case, but you can't exactly stand up in the doctor's office and shout "liar liar pants on fire!". Well, not if you're holding a screaming toddler at the same time.


Michelle said...

My dye test was totally painless... no worse than any other exam "down there".

Dora said...

Okay, I'm assuming the RE wants to do a sonohystogram (SHG AKA saline sono) and a hysterosalpingogram (HSG AKA dye test). The SHG is for visualizing the interior of your uterus, the HSG is for checking your tubes. I found them both "uncomfortable" in different ways. But, girl! You've been through childbirth. This is NOTHING!

I found the SHG pretty uncomfortable, but I have a very crampy uterus. You might ask about taking some valium beforehand to relax the muscles. On the upside, it's quick, then the discomfort is over.

The HSG takes longer, as they take x-rays of the dye going through the tubes. I didn't find this as uncomfortable, since the volume of dye is not as much as the volume of saline during the SHG. For me, the discomfort was afterwards. I was crampy for a couple of days. But really no worse than menstrual cramps, and I was probably crampy due to the big polyp they found in my uterus.

It's really hard to quantify these tests. Some women have a hard time with them and some find it to be no big deal at all. But even at worst, not awful.

Glad you're moving on to the big guns. I think it's time.

Aurelia said...

I'm with Dora on how it will be not so bad cause you've given birth. Take some advil for sure, and no, don't take the baby!

As for childcare, really CALL ME. You can drop her here, or I can meet you there anytime. Ok, 7 am is pretty early, but I'll deal if you need it.

Elizabeth said...

Oh, that sucks.

For me, the HSG was more emotionally difficult than physically. I didn't need any pain meds.

Hope it goes well for you...!!!

Dora said...

You are absolutely right. The SHG isn't going to tell him a damn thing about your fallopian tubes. Grrrrrrr!

Ms. Perky said...

I absolutely don't understand why he would do an SHG to see your tubes. You can't visualize the tubes on an SHG. Frankly, I can't believe you've never had an HSG done - and I think it's bad practice NOT to do an HSG before doing IUIs, because how do you know the eggs are making it to the uterus if you don't know if the tubes are patent?

I found my first HSG mildly uncomfortable (once they got past my cervix) and my second HSG excrutiatingly painful (when I had a blocked tube). My SHG was not terribly painful, just crampy and somewhat uncomfortable. Everybody varies on these things, though.

Regarding IVF and eSET - my clinic did a fairly comprehensive study that showed that if you go to blast, there is no increase in the success rate of 2 vs. 1 embryo transferred, only an increase in the risk of twins. (This is different than comparing 2 embryos transferred on Day 3 vs. 1 embryo transferred on Day 5) - don't know if that helps you at all, but I'll be happy to send you the study if you want it.