TTC Testing

Mommy&Mum

Good day ladies,

I gotta question, what testing have you done before TTCing and what tests if any have you done after a few failed cycles?

I have had 4 failed cycles, well cycle 3 ways technically counted as a chemical cause hcg was 8 but never went up. We are now back on the TTC train well almost! And just wondering if anyone has done more than a sonohysterograph and after how many cycles.

Thank you in advance for sharing!

I'm debating wether to do the sono again after being on a long break or pushing for something more invasive such as hydro-laparoscopy. Thanks for reading.

2MamazInSeattle

Have you had an HSG? I only suggest it because it's not super invasive (I had a very easy time of it, others I know it's been much rougher for). But for me, it showed one tube completely blocked and the other not much better - in other words - there was no way I could get pregnant off an IUI, and it took about 10 minutes to learn that. Of course it was not great news, I had to get my tubes removed and then do IVF - BUT, better than going on and on hoping, failing and wasting time.

My 2 cents .

Also you might re-title this post something like "TTC Testing" because people may perceive it as a "test post" and not read it!

Amber&Reva

I would second 2mamazinseatle and suggest getting a HSG.  It was awful for me because I tend to pass out and happened to pass out during the procedure however, after it was over other then some minor cramping it wasn't bad at all.  I have read getting an HSG actually increases chances of conceiving for the cycle or two after which is just another added benefit.

Mommy&Mum

Thanks for writing back ladies! I have not had a HSG but I have done a sonohysterograph when we tried last time and all was good. But it has been well over a year since our last cycle. Just wondering after how many more cycles before more invasive tests. I need to be an advocate with my dr!

StacyLH24

I agree with having a HSG, though mine apparently didn't show my septum to be as bad as it was. I had a hysteroscopy and laparoscopy after three failed cycles. I already had a suspicion that I had endometriosis though and had also been told that I had a bicornuate ute. It was my RE's idea that we do surgery after three failed cycles. I am glad we did. Without it, I would not be able to carry a pregnancy to term. At this point, the removal of the endo was pointless, but at the time it was hopefully going to help.

I did have a chemical pregnancy when we actually did an IUI after the surgery. Maybe it all did help...it's hard to say for sure.

Jazibel

I have to agree with the HSG, which we had done after 5 cycles.  Our RE also said it can improve your chances of conceiving because I think the liquid they use helps open the fallopian tubes (I could be remembering this wrong so don't quote me ;-)  It was fast and easy and covered by insurance. I'm guessing you've done all the other blood work?

Mommy&Mum

Does anyone know if a sonohysterograph and HSG is the same or comparative test?

Mommy&Mum

I have had the one with the saline before and was thinking that I should have a second one done before trying again this time. Last time all looked great! Apparently! I'm wondering if I should push for another test my clinics offers called transvaginal hydro-laparoscopy rather than re-doing the SHG this time. Ahhh

Mommy&Mum

@CrazyAunt84‌ have you done any iui's before?

Amber&Reva

I may be way off but I think the HSG makes sure your fallopian tubes are clear where as the sonogram checks for scaring or abnormalities in your actual cervix.  I have had both done.  The HSG was more invasive in my opinion (mainly because it hurt a lot more and the balloon they tried to use to insert the dye didn't work on me).  I didn't have the sonogram until after my loss I had the HSG prior to even starting IUI's because the doctor felt there was no reason to start if we didn't know if my tubes were working correctly.

Mommy&Mum

@CrazyAunt84‌ 2 follicles is great!!! What is your protocol? Wishing you lots of luck!

My dr does the SHG and I had one over a year ago. Wondering if I should just do it again then ask for THL. I believe SHG and/or HSG are the two test most RE's start with. But what's next and when to do them is what I really wanna know. My dr is so lax and says I'm young and healthy and ok. I want him to prove it!

Mommy&Mum

According to my clinics website this is the info on Transvaginal Hydro-Laparoscopy (THL)
Transvaginal Endoscopy (TVE), a combination of hysteroscopy and transvaginal hydrolaparoscopy, is a revolutionary technique used for direct visualization and assessment of the entire female reproductive system. The procedure is done under light sedation with only one needle puncture to enter the abdomen through the vagina and behind the uterus. A Normal Saline solution, instead of CO2 gas, is used to visualize the entire female pelvis directly. Post-operative recovery is fairly quick, with most patients feeling back to normal within hours.

It is important to note that subtle uterine and pelvic pathology can only be diagnosed under direct visualization. This novel procedure allows for the accurate diagnosis of infertility causes when other basic tests fail to reach a diagnosis, leading to the frequently inaccurate diagnosis of “unexplained infertility” (basically, a diagnosis that is reached when physicians run out of answers to explain the real cause of infertility). Remember, having a real diagnosis is the most important step in managing fertility patients.

After 4 failed cycles is it too early to strongly request the THL? Keeping in mind that my SHG was great over a year ago. Going crazy debating wether I should just go for the SHG again before starting or pressing for the THL.

2MamazInSeattle

Ok so that write up looks intense! I had both the sonohystogram and the HSG.

HSG checks to make sure your tubes are open and sperm can actually get to your egg.

The saline ultrasound is a way to look at the cavity of your uterus and your cervix on the way in. I had one after my loss to check for retained tissue or scar tissue (and lucky me, had some scar tissue that had to be removed before I could try again).

So they are totally different tests, one looking at tubes, and one looking at your uterus. Neither one was any sort of big deal for me - lasted 10 minutes or less, I had about 10 minutes of cramps after the HSG, nothing after the saline ultrasound. The procedure above sounds a lot more expensive and involved. I might ask about these two procedures to see if they might answer most of the same questions.

CageyMack

I agree with having the HSG.  There was a pretty interesting study that found that rates of conception went up the cycle after the HSG, but I can't find it.  Related more to the iodine based dye, too.  But there is also some skew to the study, such as people were more likely to have the HSG right as they went into a good RE, and were therefore more likely to get pg.  So take it as you will.

I had a saline and an HSG done before I started.  Also, and I don't see it mentioned, I would  make sure they are pulling blood work.  This can give a good idea of the "working" age of your eggs.  I was just starting to have less-than-stellar eggs, and so from the beginning we went for a slightly more aggressive treatment (and I was exceedingly lucky and got pg on the first IUI). 

Good luck!

Mommy&Mum

Thank you so much everyone. After not trying for over a year my dr only wanted me to do some initial blood work which I think only checked for rubella and stds. And didn't any to re-do SHG!!

According to his website they check the tubes in the SHG. "Sonohysterography is a technique developed to better image the uterine cavity. It uses an infusion of sterile saline solution through a soft plastic catheter placed in the cervix in conjunction with transvaginal ultrasound. The saline infusion distends the uterine cavity and provides an excellent contrast to the lining, giving improved visualization of uterine and endometrial pathology. This technique can also be used to assess the fallopian tubes by demonstrating fluid spill into the pelvis. Special techniques for tubal imaging include use of colour doppler technology to demonstrate the movement of ultrasound contrast medium within the tube itself, while specialized media can be injected into the tubes to provide unequivocal evidence of tubal patency.

Sonohysterograms and hysterosalpingograms both had notorious reputations as painful tests, however, in experienced hands, these tests are well tolerated and cause minimal discomfort."

I don't know what to believe or do anymore! Feeling frustrated!

Mommy&Mum

@CageyMack‌ yay for first iui success!! What was your protocol? All my previous cycle have been with Femera resulting in one mature follicle each time, I usually started to surge on my own too and took the trigger as a booster and iui the following day. After iui I was on prometrium until beta test.