Who here has had an HSG? How about an endometrial biopsy?

ECUGirl2004

I saw the nurse at the birth center a few months ago to talk about my spotting issues.  We checked my hormone levels (which were all good) and when I saw her again, she told me that an HSG and an endometrial biopsy were the likely next steps to find out what's causing all the spotting.  I've already had an ultrasound and all looked good, but apparently they can miss some things.  Anyway, I'm 5 dpo today and I had some spotting this morning.  I'm thinking of going ahead and scheduling both procedures for next cycle, if they can do them during the same cycle.  Maybe they can even do them on the same day?  IDK.  I figure if I happen to get a BFP this cycle, I can just cancel the procedure(s).

So, tell me about the HSG.  If I recall correctly, it seems like some people have no problems with it and other people find it pretty painful.  If you're in the Triangle area, where did you have it done and what was your experience?

TIA!

elizabethswan

if you are a friend of Emilee on facebook, you might want to message her there. I know she has had it done & she is in the area, but don't think she comes on here anymore.

 Sorry you are having issues, hopefully you won't need those appts!

ETA: she's had the HSG, don't know about the other

H&W05

I've had the HSG. The entire procedure was uncomfortable but the only really painful part for me was when they shot the dye up. (At least I'm assuming thats what it was). I was fine the rest of the day. Just mild cramping.

Jenandtonica

When did they check your progesterone levels?

I had a HSG. As someone who's given birth med-free, I can't imagine it'd bs tough for you. Well, provided you don't have Em's experience. Most are painful and often compared with labor pains (which my RE poo-pooed), but the procedure is usually quick. Afterward, you might be crampy, but it doesn't last for days & days.

Again, that's a "normal" HSG experience.

ECUGirl2004

J&T - they checked my progesterone at 6 dpo.  7 dpo was on a Saturday.  They were 13.something, which is good for an unmedicated cycle.  Despite that, we decided to try progesterone suppositories to see if it would help.  I tried them last cycle and if the spotting keeps up this cycle I won't be using them again. 

Despite having a med-free labor, I found IUD insertion to be very painful, and it makes me nervous about having an HSG done.  I'll do whatever I need to do, but I might take a klonopin before I go. 

veronicacorningstone

I was so caught off guard by the HSG.  I thought it would be similar to a pap smear.  The joke was on me!

My experience was so damn painful.  I wish I would have taken a Tylenol beforehand, but my ob/gyn didn't tell me to and I was the idiot and didn't really research it.  A lot of people take pain relievers, which I believe could help.

I had extreme cramping when the dye was injected into my tubes.  One of my tubes has some dye pooling in it and it was slow to empty out, but it did empty out so my tube was open...but I was told that could be why I had such bad cramping.  I definitely don't think my experience was "normal" though.  Good luck!

alchris

Did she say how she thinks an HSG will help answer about the spotting?  It's usually just to look to make sure your tubes are not blocked.  Alternately, an SHG can look through your uterus to find abnormalities like scar tissue or polyps.

A P4 of 13 at 6po should be fine.  But you're right, P4 suppositories *should* help -- they solve the problem for most women I know!

I'm sorry I don't know as much about the biopsy.  What procedure are they going to use?  I had a hysteroscopy to remove a polyp in March and it wasn't bad.  Many women have a laparoscopy to look for and remove endo.

I was one of the unlucky ones as far as the HSG, but I'm thinking that being post-childbirth (mine was before Kira) may help you out there???  Many women say it feels just like a pap, and most say it's not bad...mine unfortunately hurt horribly though.  The good news is that as soon as it was over, I felt 100% normal, no cramping or anything.

Keep us posted, OK?

ECUGirl2004

alchris - It's entirely possible that I got my acronyms confused.  It was a few months ago that we talked about all these procedures, and at the time I wasn't ready to take that step.  I was just convinced that the issue was progesterone, but if the spotting has continued with 2 cycles on progesterone, then I'm guessing that it wasn't the issue after all. 

I'm also not sure about the biopsy procedure.  I've read online that there are a few different ways they can do it, but I would imagine that the doctor decides based on each person's circumstances.  I guess that the biopsy would help to determine if there are polyps or endometriosis.  I dont' have any endo symptoms (other than the spotting), but I'm convinced that there's some reason that I keep spotting and I want to know what it is.

I left a message for the nurse at the birth center, so I'm waiting for her to call me back and I can get more answers then.

alchris

Gotcha.  And FWIW, my SHG felt like just a regular vaginal u/s!  No pain AT ALL, just wet from the saline!

And yes, given that the P4 hasn't worked for you, I would think an SHG would be a non-invasive way to have a thorough look in there, since it indeed could be something physical, not (or only in part) hormonal.

Let me know what you find out, OK?

flamencogal

I'd have to look back but I had my HSG at either Wake Radiology or Raleigh Radiology.  Most of the HSG was OK--for me, it was when she inflated to balloon that I about jumped off the table-I did literally wince and jump.  If she had warned me, I would have been prepared but she didn't and it caught me by surprise.  So it hurt for those few seconds and the rest was not pleasant but not awful.  The doc who did mine was awful--didn't really talk me through it and then forgot to remove the speculum!  The tech had to remind her to take it out so I could get up.  And from what I understand, the HSG is to check anatomy--tubes clear? uterus shape normal? that sort of thing. 

ETA: I think it was Raleigh Radiology with Van Vickle--I could be wrong though--I had it done about a year ago. Oh, and definitely take at least advil before you go in.

 

jenwill

I'll be honest, my HSG was horrible and I had no issues (blockages, etc). For me the pain was from inserting the catheter through the cervix (which I ended up finding out I had cervical stenosis-so prob the reason it hurt so bad). Crampy after, but not bad.

Are you seeing an RE? I would def suggest getting in with one if you haven't yet. I'm not sure about an endometrial biopsy as a first-line test and I would question that. HSG yes, biopsy no. They never mentioned that when we were TTTC and I had abnormal bleeding as well (with normal labs). We had discusssed laproscopy would be the next step with a normal HSG (but usually that's not right off-maybe after trying medicated cycles).

Are they doing lab work any other time during your cycle? I had lab work around day 21 as well if I'm remembering correctly. Have they checked any other labs besides progesterone?

ECUGirl2004

jenwill:

I'll be honest, my HSG was horrible and I had no issues (blockages, etc). For me the pain was from inserting the catheter through the cervix (which I ended up finding out I had cervical stenosis-so prob the reason it hurt so bad). Crampy after, but not bad.

Are you seeing an RE? I would def suggest getting in with one if you haven't yet. I'm not sure about an endometrial biopsy as a first-line test and I would question that. HSG yes, biopsy no. They never mentioned that when we were TTTC and I had abnormal bleeding as well (with normal labs). We had discusssed laproscopy would be the next step with a normal HSG (but usually that's not right off-maybe after trying medicated cycles).

Are they doing lab work any other time during your cycle? I had lab work around day 21 as well if I'm remembering correctly. Have they checked any other labs besides progesterone?

Thanks for such a thorough response!  No, I'm not seeing an RE. I'm seeing the FNP at the birth center (where Nate was born).  I went there b/c they understand charting and I knew they'd take me seriously and really listen to me.  I haven't contacted an RE because it hasn't been a year of TTC yet.  IDK if one would see me. 

I've had a ton of labs done... we tested FSH and LH, she did a CBC, tested thyroid, and the progesterone (which was done at 6 dpo, same as the day 21 test).  I think there was more, but I can't remember.  Everything came back normal.  She also did a vaginal exam, to look for polyps on the cervix or any other abnormality and said that everything looked/felt normal.

Right now I've got a tentative appt set for my next cycle to do the biopsy.  Before that, the nurse is taking my chart to chart review to talk to the other midwives and their OBGYN to see if they suggest a different course of action.  If I get a BFP before then or if they recommend something else, I'll cancel that appointment.

jenwill

ECUGirl2004:

jenwill:

I'll be honest, my HSG was horrible and I had no issues (blockages, etc). For me the pain was from inserting the catheter through the cervix (which I ended up finding out I had cervical stenosis-so prob the reason it hurt so bad). Crampy after, but not bad.

Are you seeing an RE? I would def suggest getting in with one if you haven't yet. I'm not sure about an endometrial biopsy as a first-line test and I would question that. HSG yes, biopsy no. They never mentioned that when we were TTTC and I had abnormal bleeding as well (with normal labs). We had discusssed laproscopy would be the next step with a normal HSG (but usually that's not right off-maybe after trying medicated cycles).

Are they doing lab work any other time during your cycle? I had lab work around day 21 as well if I'm remembering correctly. Have they checked any other labs besides progesterone?

Thanks for such a thorough response!  No, I'm not seeing an RE. I'm seeing the FNP at the birth center (where Nate was born).  I went there b/c they understand charting and I knew they'd take me seriously and really listen to me.  I haven't contacted an RE because it hasn't been a year of TTC yet.  IDK if one would see me. 

I've had a ton of labs done... we tested FSH and LH, she did a CBC, tested thyroid, and the progesterone (which was done at 6 dpo, same as the day 21 test).  I think there was more, but I can't remember.  Everything came back normal.  She also did a vaginal exam, to look for polyps on the cervix or any other abnormality and said that everything looked/felt normal.

Right now I've got a tentative appt set for my next cycle to do the biopsy.  Before that, the nurse is taking my chart to chart review to talk to the other midwives and their OBGYN to see if they suggest a different course of action.  If I get a BFP before then or if they recommend something else, I'll cancel that appointment.

GL! Hope you get some answers!

If you do decide to go the RE route, I think they would see you even if it hasn't been a year. Esp if you're having abnl spotting during your cycle. I went to Duke Infertility Clinic and would be happy to give you my dr's name if you are interested. Everyone at that clinic (I did see other drs on occasion) was wonderful, really took the time to listen to me, very caring and compassionate. And they get the charting, in fact, encourage it in the beginning stages of seeing them. 

MRSGOLABONTE

I just had my second endometrial biopsy a month ago. THe first one was HORRID. I was already in pain from just having gotten out of the hospital, and I didn't have any pain meds beforehand.

 I was sooooo nervous this time around, because I remember how bad it hurt the first time and how I SCREAMED the F word over and over during the procedure. This time I took 800mg Motrin about an hour or two beforehand. The nurse I had gave me a heating pad to put on for 5-10 minutes before, then keep it during and after the procedure. I was AMAZING! It felt easier than a pap smear! I had to go back there a few weeks ago, and I told her it was her duty to make sure every nurse in the world learns the trick of the heating pad for that procedure. She said she's always had great results that way. I would demand it if I were you!!!!