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?