Fertility Specialist Appointment

Monday, April 19, 2010

Our first appointment with the FS went well. He was lovely and put me at ease straight away.

Got straight down to business. Took a look at my referral letter and BT results my GP had done, then looked at DH's results (which we just had faxed over). We held our breath as he looked over DH's results as this would be our first time hearing the good/bad news. DH's results are all NORMAL!!! 

Woohoo!! So we can cross him off the problem list! 

FS asked a few questions regarding my cycles, medical history etc. All pretty straight forward. Then jumped straight in to the where to from here...

Firstly he wants me to have more bloods done..AMH (which looks at my ovarian reserve) and will have the tests done on CD22 so they can make sure I am ovulating.

Then I have a referral letter to get a HyCoSy done.

What is a HyCoSy?

Hysterosalpingo-contrast-sonography (usually shortened to HyCoSy) is a simple and well-tolerated outpatient ultrasound procedure used to assess the patency of the fallopian tubes, as well as detect abnormalities of the uterus and endometrium.

The first part of the HyCoSy is like the first part of a pap smear, with a vaginal speculum gently inserted into the vagina to visualise the cervix. The cervix is then cleansed with antiseptic solution to decrease the risk of infection. A thin flexible balloon catheter is inserted through the opening of the cervix, so that the catheter lies within the endometrial cavity. Inserting this intrauterine catheter does not usually cause discomfort. A tiny balloon at the tip of the catheter is slowly inflated with saline – this is necessary to stop fluid leaking back out through the cervix during the test. Inflating this tiny balloon can cause some discomfort. The vaginal speculum is then removed, with the catheter remaining inside the uterus. Next, the transvaginal ultrasound (internal scan through the vagina) is used to image the uterus. Initially, a small amount of sterile saline is introduced into the endometrial cavity through the catheter, as occurs with a saline sonohysterogram. This saline distends the endometrial cavity, allowing assessment of the contour and shape of the cavity. The doctor will be looking for such problems as endometrial polyps, submucous fibroids and congenital uterine abnormalities (such as uterine septum).
Next, a small amount of the contrast agent Levovist will be introduced through the catheter. The doctor will be looking at both fallopian tubes, to see if the tubes are patent. If the contrast can be seen flowing through each tube, and spilling out the end of the tube into the area around the ovaries, the tubes are patent.
The transvaginal ultrasound and catheter are removed at the end of the test.

I have to wait until next cycle (once AF has been and gone) to have this done.

If all the results come back clear from these tests, then we have to keep trying for another 3 months. Apparantly sometimes after having the HyCoSy done some women end up falling pregnant in the subsequent cycles.

Then if I am still not pregnant after those 3 months we have to go back to see him and he will do further investigation to see what the problem is. Probably scans, ultrasounds etc and then he said the next step would be stimulation drugs and then IUI.

So next step is to get BTs done next Tuesday, then HyCoSy next cycle (between CD7-10).
I asked him about continuing with my temping and he said not to bother. His thoughts on temping was that it is quite an old fashioned technique and not very reliable as too many things can impact the results. He said these days it is better to get scans, BTs etc to check up on ovulation.

So after all my obsessing over temping and charts..he didn't even look at them!!!

I am feeling a little let down..I think I expected too much from the first appointment, but to think of waiting another 3 months after these tests is quite frustrating. It will then put us over the 12 month TTC mark which scares me.

I just feel like despite having all normal results so far and being able to see the FS, we are getting nowhere fast and I am just tredding water..

My ticker is approaching 40 weeks of TTC..I can't believe that I could almost have a baby by now!

I am at a loss as to what to do now..I guess I get the tests done and hope there is nothing wrong. Then we just wait out the 3 months and see what happens from there. Perhaps I should be really positive and hope that I get pregnant this cycle and I don't even need to bother with the HyCoSy...