HSG ... TBD.

So! It's been a couple few days and I forgot to update on my HSG. I took my antibiotics for two days. At noon, I came home from watching a friend's babies and went to the bathroom.  On the way home, I noticed I was getting some strange cramping but thought nothing of it as it was a little less than a week after my period and I had been taking BC pills for almost a week.

Sorry for the TMI--but I wiped and WTHeck?! Full blown period!  I was half-bummed, but I would be lying if I said I was truly upset. I called Arcadia Radiology and told them about the strange period super-flow. They said it was up to me and my Dr if I wanted to do the test still.  I said I'd really rather not have this awful test for one, and especially not if I'm bleeding profusely.  She said she completely understood and to call back when the bleeding had stopped to reschedule.  A sigh--a huge sigh of relief.  Meanwhile, I continued looking online for other women's experiences on their HSGs, just to further torture myself and work up the gall to reschedule.  Then, I began to question just how much I really needed this test.  Hear me out before you decide I'm just a big, fat chicken.

I know the HSGs fun side effect is to increase a woman's fertility. The actual need for it is completely diagnostic, but they've found that after performing the HSG a woman's fertility was measurably increased.  From what I've read, this is usually in reference to IUI and IVF.  As of now, we'll cross the IVF bridge when we get there so in that regard, there's no need for increased fertility in the IVF department as it's something we won't be doing for at least a year from now.  IUI isn't covered under our insurance (most insurances), so monetarily that's something that's not in our immediate future, either.  Bottom line, my Dr doesn't expect any tubal problems or uterine problems (as seen on the transvaginal ultrasound)--she was merely using this as a fertility enhancement.

I think I will call the office Monday morning, or perhaps tonight and leave a message.  It would be ideal to try the Clomid and see what happens from there. If it gets to the point of several unsuccessful cycles of Clomid and Metformin, then I think it will be easier to work up the gall to want the HSG. Right now it feels kind of like jumping the gun when I'd really rather not fill my uterus with contrast material.  And of course, there is risk of infections (pelvic infections), scarring (which on its own can lead to infertility) and damage to the uterus and fallopian tubes.  Granted, I think all these risks are low, but they are still there and I feel for my body, the less I have to do to it the better.  I have enough obstacles in my way, as is.

The Dreaded HSG

Hysterosalpingogram, fondly referred to as an HSG. 


A little back tracking. I'm not sure that I've mentioned this, but DH [dear husband] and I have decided to try for children. I know I mentioned the idea previously, but months back we actually decided to try 100%. Dr Chen started me on a 10 day course of Provera which is used to initiate a period, in my case, to freshen up my uterus and get it ready for baby. I started my period 6 days ago.  She also started me on Metformin [850mg, 2x daily]. I started birth control [Apri] on the 5th day of my period [yesterday]. I will be on BC pills for 2-3 months, as most women continue to have semi-regular periods for 1-3 months after stopping BC pills while the medication gets out of their system. This is our hope for me. That my body will continue to work somewhat normally after discontinuing the pills. In addition, I will be starting on Clomid, though I'm not sure the time or the dosage. Clomid is used to induce ovulation.  

L-R:Antibiotic, BC pills, Metformin, Prenatals w/DHA for brain function/development for baby

The Metformin is to my understanding, something I will be taking from here on out in general.  It's also been suggested by many medical journals that it helps in early term miscarriage. Well, helps in lowering the chance of them. Dr Chen said after she heard a heartbeat into my pregnancy, that we'd discontinue the Metformin as it's also unclear if the medication causes a higher rate of birth defects. Oh, and did I mention that Clomid raises the chance of multiple births? Maan.. I'm not going to say I don't want twins because I just want my baby(s) to be healthy, but it would be just my luck that I'd be blessed with two little monsters.


On to the HSG. An HSG needs to be preformed within 6 days (the earlier the better) of your last period. Reason being, they want to make sure you aren't pregnant as I suppose it couldn't be good for the fetus. When Dr prescribed the test, I didn't think too much of it--until she explained it to me.  Essentially, they use a speculum to open your vagina, insert a tube through your vagina and into your cervix. Then, they proceed to fill your uterus with contrast material until the contrast flows out your fallopian tubes.  It's used to get a better picture (many x-rays are taken during this procedure) of your uterus and to clear out your tubes. It's been noticed that a woman who has this test (though it is technically used for diagnostic purposes) have better luck with fertility treatments. 


My uncertainty stemmed from the prescription of antibiotics Dr gave me, and the 800mg of Motrin she told me to take an hour before the test. Apparently, you can get strong contractions (much like birth, I'm told), and a good amount of pain from this test. Oh, great. Then, of course I made the mistake of researching other women's testimonies after their HSG tests. The most common statement I read was, and I quote 'I will NEVER have this test again! NEVER!' end quote. Super!


Well, wish me luck, pray for me, keep me in your thoughts--I'll take what I can get, as my test is this Tuesday.

Diagnosed.. Eventually.

It's difficult to say whether or not finally putting a name to this monster is a positive or a negative experience. I suppose it's a bit of both. First of all, it's darn near impossible to get diagnosed. There are so many symptoms of PCOS and not any one woman has the same symptoms as the next.  Some have multiple, healthy children while others struggle with infertility their whole lives. 

So. As I was saying in the previous post.. it was [past] time for a specialists opinion. I needed some answers so we could get this thing figured out.  First, I went to a regular endocrinologist. She was nice, and  in-network for my insurance. Perfect! Well, we did the excessive blood work--literally everything from cholesterol to STDs to FSH. It was 'hard' on a few of the hormone tests because neither myself or my Dr had any way of knowing which day of my cycle I was in, because that year I had only had 3 periods (this was October, 2009). My guess is that your hormone levels vary in range depending on if you're ovulating, menstruating, etc. That's my guess, at least.  Either way, I get an email from my Doctor--who specializes in diabetes and hormone/endocrinology--everything is fine. No STDs (thank God), everything else is within range. A sigh of relief. But wait, what the hell? Is that it? I made an appointment to go see her the following day. We went over my blood work results briefly. I nodded and agreed on most of what she had to say. My total testosterone was on the high end of the 'normal' scale. But, still in range. There were a few other things that were the same result. High end of the scale, but still... on the scale. 

I finally asked. Well, what could be the problem then? I had come to her with the suspicions of being diagnosed with PCOS. She had asked me what made me think I had PCOS. I said, well mostly the absent period, but there were a few other minor signs. After going over my blood work she said there were plenty of other things it could be. One being, unexplained infertility, or premature ovarian failure, or that I was entering menopause early and had no eggs left. All of which there is zero treatment for. I was in tears leaving the Dr office. 

Almost a year to the day, I got in a tiff (with myself) as I was going back to that diagnosis in my head. I had joined a support-type message board that I hadn't been active on at all since the lack of PCOS diagnoses.  I was sifting through some posts about how people had frequently been misdiagnosed in the past; most had gone through 2 or 3 doctors before finally getting positively diagnosed with PCOS! This instilled a bit of hope that there might be a way I could have also been misdiagnosed. A sidenote: No one HOPES to get this disease. No one in their right mind. But, after being told I had premature ovarian failure, I was hoping for a light at the end of the tunnel. Any light. After a year of casual research, I had come to find out that there are in fact medicines for ovulation, both prescribed and holistic. 

Again, I made an appointment with an Endocrinologist. Though this time, I chose a Reproductive Endocrinologist. I had learned that RE's had to first be OBGYNs, then study endocrinology--and, voila! We have a reproductive endo. 

I immediately felt at ease with this Dr.. Partially because I had already heard the worst diagnosis, in my mind. How bad could it be, really? This Dr, I loved. And I do mean love. The walls of the exam room were plastered with Christmas cards, birth announcements, and photos of successful pregnancies and healthy offspring. It made me happy.

Dr. Chen came in, introduced herself, and was jolly (yes, a bit overweight--which really made me giddy). She took me to her office where she then began from the beginning. From my first period to now. I mentioned my previous diagnosis. She didn't give it the courtesy of a thought or a mention.  She said from what I'd told her, she suspected PCOS. I was shocked. I hadn't mentioned it once. She took me back to the exam room for a transvaginal ultrasound. And there on the screen was something I'd seen in ultrasounds all over my SoulCysters message boards: Polycystic Ovaries. A dark, egg shaped ovary (both, actually), lined with the typical 'string of pearls.' I said, ".. is that..?" She confirmed and said without a doubt I had PCOS. 

She ordered blood work to firm up the diagnosis. I went and did it the next day and came back to her office for a follow up a week later. Why the previous Dr hadn't caught anything in the blood work was beyond both of us. I didn't have diabetes, thank goodness--but my insulin was through the roof.

So, what next?

What's wrong with me?

 I can't remember a time in my life where I felt like a normal girl or young woman.  My period has never been regular. When it first started, sure.. it's normal not to be regular. But that regularity of a monthly period never came. The most regular I ever managed to be was 6 periods a year. About once every two months. I always knew this wasn't right. I saw a doctor when I was about 15 or 16 with my mother and we were told that it was completely normal not to have a regular period for the first few years after getting your period. Life went on. At 18, still knowing something was 'wrong' with me, I battled with the need for getting a pap. I researched it online and decided I was too scared to find an answer to my problems. Was it cancer? My grandmother died of ovarian cancer. I didn't like any of the plausible options I could come up with in my 18 year old head, so I made the decision never to get one.

Finally, at age 26--I had my first pap smear. What had finally spurred my butt into gear was that I had just recently been married and the subject of our eventual offspring came up. Before we even started actively trying to conceive, I knew what I had to do. My Dr said that they would call me in a few days if something came back abnormal. Those were the longest few days of my life. I received a letter in the mail from my Dr's office saying that my results came back completely normal, and to call for another appointment, same time next year. A sigh of relief. I was fine then, right? At this point, I was so uneducated in the field of  female reproduction, I had no idea this was just the first step to many others I would soon have to take.

Now came the next hurdle. I always had this gnawing feeling in the pit of my stomach that I was going to have difficulty getting pregnant. As I got older, that feeling turned to a certainty that I would never be able to become pregnant. I wasn't even entirely sure why. I knew periods should be normal in a healthy woman, but I had no idea you could still ovulate in the absence of your period, that there were drugs to help you menstruate/ovulate.

Still knowing something was amiss, I turned to the internet. Wow! Why hadn't I done this sooner? Oh yes, that's right.. I was scared to death of what I may find.  Now that I was thinking not only about myself but my new husband, our furbaby Pavi and prospective mini-Garcia's--well now that changed everything.  I needed to find out what was wrong and fix it as soon as humanly possible. This led me to (among other things: many other things) PCOS. I started scrolling through symptoms and darn near swore out loud when I came across the myriad of things that were related to PCOS. No, not just infertility and menstrual irregularities.  Seemingly unrelated things. Weight gain, predominately around your midsection. Check. Irritability and severe mood swings. Check. Hirsuitism. Wait.. I always thought that was because my father was Arabic and it was a dark skinned thing? Check, check. And, as I would later learn, a whole slew of other blood work related things that attributed to my difficulty in losing and maintaining my weight my whole life.

I continued on and became quite the avid internet article reader.  At this point, I knew I needed to see a Dr. A specialist. Someone who could really help me sort through this..