Why not an HSG? (baby picture in siggy)

erpetdoc

I started spotting today, ending the first medicated cycle.  I already knew I wasn't pregnant, though, as I had estrogen, progesterone, and a beta pulled yesterday morning.  The nurse told me to stop the progesterone supps (estrogen had dropped to 33) and wait for AF. The RE classified this cycle as a clomiphene citrate challenge test cycle, but it still "counts" as the 1st of 3 cycles that she is willing to do Clomid before moving on to injectibles and/or IVF.  

As I am about to embark on the second Clomid cycle, I have a question for you who have been doing this longer than I have, and know more information.  In my initial diagnostics, the RE ordered a saline sonohysterogram, but not an HSG.  I understand the information is similar, but the test I had tells her nothing about my tubes.  I have had two previous pregnancies, one a miscarriage, and one resulting in my daughter.  Is that why she didn't order an HSG?  Is it possible for something to have occurred in my tubes since my daughter was born that would make it now difficult to achieve pregnancy?  Should I  push harder to get an HSG?  

This second Clomid cycle will have zero insurance coverage, and will include an IUI.  I don't necessarily want to pay for this cycle if there's a potential that a diagnostic that is crucial to my treatment has been overlooked.  If having an HSG would change the diagnosis/treatment plan, then it doesn't make sense to me to do an IUI cycle.  If it matters in your answer, I'm being seen by an RE for a luteal phase defect.  My unmedicated cycle resulted in a 5 day LP, and prior to seeing the RE, my LPs were between 5-10 days (except in one cycle that I was on 400 mg of progesterone twice daily from my OB, and had a 15 day LP).     

 

BzeetyD

After my 2nd pregnancy one of my tubes became blocked and I had a suspicion that something was up and actually pushed for a 2nd HSG but was told "we know they're open" - until I had a laproscopy, then they did an HSG while I was under and tried to open the tube but it wouldn't.

I would consider asking for a HSG again and explain your reasoning. 

Also my understanding from my docs are that tubes can be open and be closed and not necessarily remain either way. As an example, my closed tube could now be open.

lady_chance_99

My RE said that she was able to tell that my tubes were open because when she did the SIS she (and I don't know HOW she did it) blew bubbles up my tubes which told her the tubes were open... perhaps your RE did something similar? GL