Thursday, September 13, 2007

Infection from Hysterosalpingogram

September 13, 2007
Two nights ago I woke up at 3am with a fever of 101. I hadn't been feeling like myself for a couple of days, and even though I was on antibiotics I was convinced I had an infection.

I called the Dr. the next morning (yesterday) and she had me come in right away. They took my temperature and pee and also then we went into the exam room for a transvaginal ultrasound.

In the room I layed down while she inserted the ultrasound device, and I was able to watch on a flat-screen monitor near the ceiling. I don't know how the Doctor can see the things that she can see, but she pointed out different areas to me on the screen.

She saw all my female parts, and I have a fibroid. She said that it appears to be far away enough from the lining of my uterus as to not cause a problem with conception.

She saw a "collapsed follicle" which signals that I had already ovulated and the egg was on the move. The follicle is what signals for your body to release progesterone. The progesterone heats up your body to keep it warm enough for the potential of a pregnancy.

She also saw my right fallopian tube, which when healthy she shouldn't be able to see with the ultrasound. She told me that she hasn't seen the x-ray photos yet, but that based on the information reported by the radiologist I had a "hydrosalpinx". This was being confirmed by her seeing my fallopian tube in the ultrasound.

A hydrosalpinx is typically associated with a blocked tube that collects fluid and ends up looking like a sausage. My tube is open but it currently holding fluid similar to a hydrosalpinx. I don't know yet if that means that it was created by the dye test and will calm down, or if it's permanently that way. She's going to call me after she looks at the x-ray images.

Based on what she saw she took me off the other antibiotic and put me on 2 others that are general and very aggressive. She also told me that if my fever doesn't break by Friday that I may need to go in the hospital and get IV antibiotics. Scary.

Even though she didn't want to say too much before seeing my x-ray images, she did tell me that I was not a good candidate for InteraUterine Insemination. She said that when you have a hydrosalpinx if you HAPPEN to get pregnant you have a high-risk of tubal pregnancy. This would be very bad and require a surgical abortion, in essence.

She also told me that a hydrosalpinx can ruin a cycle of InVitro because if the embryos are in the uterus the fluid from the hydro can leak out of the tube and either 1) flush out the embryo trying to attach to the uterus, or 2) poison the embryo, because the fluid is toxic to embryos.

This would mean that the most effective way for us to get pregnant now would be to have InVitro, but before that we'd need to deal with the tube. This would most likely mean removal. There are other women's blogs that I have read that say the Doctor "pierced" the tube when they went in for egg retrieval, and that way by the time they implant the tube is empty and the fluid is gone. My Doctor didn't mention that.

I'm going to try not to worry about all of this until I hear back from her. Hopefully the news will get better, and hopefully I'll also heal from this infection. :(


September 11, 2007
Well we have been trying to conceive now for 15 months. This sucks!!

I have been to the Reproductive Endocrinologist now (the Fertility doctor) and had a consultation ($275), and a blood hormone test for fsh and entradiol (both normal). Evan has had his spermies tested, and with the exception of some abnormal shaped guys his test was normal.

The next test (which I had last week) was the hysterosalpingogram. A girlfriend told me it wasn’t a big deal, but it really really was. Cost of test: $350.

I went to the radiologist’s office and was given a bag to put my bottom-half clothes into, along with an open-back robe to put on. I went into this large radiology room with lots of equipment, and a table in the center that resembled an autopsy table. I got on the table and the lab assistant explained the process to me, and gave me a box of CDs to pick one. I picked Stevie Nicks Greatest Hits.

The doctor came in, and they had me lay down and they propped a pile of sheets under my rump to lift my bottom in the air. No stirrups here, but I just had to spread my legs wide. They did a couple of “before” x-rays of my abdomen, and I could see the screen from where I was laying. My belly-button ring became the only real point of reference.

Next came the speculum. Most women are familiar with the pain associated with this metal “jack” being inserted into your vagina, usually during pap smears. During pap smears this device is only in for about 15 seconds. Well I had it in me for an hour! So he put speculum in and started screwing it open, literally like a car jack. Not cool. Then he got the catheter and started feeding it through my vagina. The goal is to get it in through the opening of my cervix into my uterus cavity. No such luck. Apparently I have a very small cervical opening, along with a uterus that is tilted forward and off to one side. He spent about 20 minutes trying unsuccessfully to get it through my cervix before removing it. Next came the French dilator. This knitting-needle like instrument is used to irritate the opening to your cervix into opening. I sat with that inside of me for about 10 minutes before he removed it and stuck the catheter back in. He thought he had it in, and thus removed the speculum, but it wasn’t positioned right and he had to reinsert the speculum. FINALLY he got through my cervix with the catheter and injected the dye into my uterine cavity, and up into my fallopian tubes. This didn’t hurt at all, but I’ve heard it does hurt some women. A series of x-rays were taken while the dye was moving through.

The Dr. told me he believes that one of my tubes had been blocked but had subsequently been power-washed clean. The bacteria gets pushed further up into your tubes, so he wrote me a prescription for doxycycline to clear up any potential infection.

I left with a CD-R of my images, and I mailed them to the Dr. A lot of women claim to have gotten pregnant just after this test, so we’ll see what happens. I’ll let you know what the Dr. has to say next.