Sonohysterwhat?

As part of moving forward with IVF, my new doctor (um, yeah I changed clinics, I think I’ll write a post about why soonest) ordered an SHG before we moved forward.  Now, when the nurse told me this all I heard was “HSG” which I’ve already had done.  He’d mentioned he might want to re-test some things since all my original testing and HSG were done this time last year.  I was fine with that.  Then I looked at the paper more carefully and realized that infertility is hell for dyslexics because my doctor had ordered an SHG.

My layman’s explanation follows:

An HSG is a hysterosalpingogram.  It involves a dyed solution being pushed into your uterus and tubes while you have X-rays taken.  This is to check that your tubes are indeed clear.  (For those who might be reading who are nervous about having this procedure, I’ll add my experience.  That was: this was pretty easy for me.  I took some ibuprofen the night before, took some an hour before the appointment, took some after.  I cramped a bit during the procedure and was a bit crampy the rest of the day, but not bad at all.  Overall not nearly the horror story I’d read some women go through.)

An SHG is a sonohysterogram.  This involves filling your uterus with a saline solution while sticking an ultrasound wand up your hooch to have a nice look at what’s going on in there.  They also had me take a three day course of antibiotics to prevent infection during this.  I didn’t do that with my HSG, not sure why. (Again, my experience: this was very easy.  The most uncomfortable part was the ultrasound wand, which I’m pretty used to at this point.  Actually, maybe the worst part was gushing water out my hoo-hah for an hour afterwards.  Minor cramping during the procedure and NONE afterwards at all.  It was much easier than I expected.)

What I did not realize is that the HSG very rarely tells you anything about your uterus.  Which is why I was sort of surprised to hear during my SHG that I have a decent sized polyp in my uterus.  Polyps can inhibit implantation and can cause miscarriage.  My new doctor recommends getting it removed before proceeding with IVF for just those reasons.  So, my question now is: WHY THE HELL DID IT TAKE A YEAR TO GET ONE OF THESE?!  Sorry for yelling, ahem.

I realize that the polyp might not be my explanation for my unexplained infertility.  But it might be and I think we can all agree it sure as hell is not helping anything.  So I left with my mind whirring.  Is this why I miscarried two years ago?  Is this why we haven’t been able to get pregnant since?  If having this removed will help my chances for IVF, wouldn’t it have also helped my chances for IUI? For natural conception?  I know that no doctor can answer those questions for me, but I’m pretty frustrated I’ve been seeing an RE for 10 months who never ordered this really super simple procedure that takes 10 minutes. My old RE was ready to proceed with IVF without even doing this! This polyp could have cost me $20k!

So, obviously I will be having this puppy removed.  This will be my first ever surgery and first time under anesthesia.  I guess it’s good practice for egg retrieval?  It’s a simple, outpatient procedure that basically involves sticking a camera in there, snipping this thing outwith scissors, and looking around a little.  Our IVF calendar will be laid out after that.  I’m itching to get started, but also kind of happy to wait awhile all at the same time.  IVF is weird like that.

Stay tuned for: venting about doctors, deciding to switch REs and pricing out IVF (shoot me) and attending our first “IVF Class” at our clinic. Good times ahead for sure.

So whose had both an HSG and SHG?  Did they tests tell you different things?  Did anyone have an RE ordered both of these before even starting treatment?  Discuss.

14 thoughts on “Sonohysterwhat?

  1. After reading numerous infertility blogs, I’ve realized that I don’t understand how doctors work. You’d think that before asking you to shell out twenty thousand dollars, doctors would do simple procedures like an HSG, SHG and simple blood work just to make sure there isn’t anything extra preventing a woman from becoming pregnant. Like you said, what if you had paid for IVF and then found out you had the polyp?!

    I understand that the procedures cost money, and doctors don’t want to have patients undergo procedures that are unnecessary, but I would much rather pay for the procedures just to find out that everything is ok, than to pay for an IVF round, find out that there is something that could have prevented me from becoming pregnant and then having to pay for another one. (Holy run on sentence Batman!)

    Anyways, I’m glad your new RE seems like much less of a turd than your old one and I’m glad both your HSG and SHG went well. I had horrible cramping for my HSG but was a dingbat and didn’t take pain meds before hand. I haven’t had an SHG yet, but if we get to the point of IVF, I’m going to request one for sure.

    • Yes Id request one for sure. As unexpectedtrip said the HSG could pick up polyps too but I think it’s worth asking about. And honestly the SHG was much easier and much less crampy than the HSG.

  2. Thanks for the info about HSG/SHG. I dunno wth is wrong with so many of the docs–sometimes I think they “work backwards” just to get more money. Sounds like you’ve made great progress though! Cheers!

    • I am too! I don’t remember hearing anything about the status if my uterus after my HSG. But it’s possible the polyp wasn’t there since the HSG was a year ago. I’m going to ask my doctor what he thinks and have him look at my HSG records.

      It does seem that HSGs can see polyps and fibroids, by it also seems like they can maybe miss them since the dye isnt the best contrast liquid. But. I’m going to do some more research before writing off my old RE as a jerk face haha.

  3. I had a similar experience. It took numerous ultrasounds, an HSG, and a SHG to find my three polyps. Because I had a history of painful periods and had an elevated CA-125 blood test, I convinced my doctors (OB & RE) to perform an Lap while they were removing the polyps. My RE initially just wanted me to forge ahead with two months of Lupron under the assumption that I had endo and would need IVF. I wasn’t ready to induce menopause just yet. So they agreed to the lap while removing the polyps and sure enough they found stage IV endo, removed it and the polyps, and I got pregnant naturally two months later (was doing chinese medicine though). I miscarried at 6.5 weeks. Ready to move forward, I decided to do ONE injectable cycle with IUI as a “practice” round before IVF. I wanted to see how my body responded to the injections so we wouldn’t have a cancelled IVF cycle. Miraculously, I got pregnant. And to the best of my knowledge still am pregnant. My point? You may consider getting the CA-125 blood test before your hysteroscopy to remove the polyps. If the test comes back elevated, they might as well do a lap while you’re under to check for endo. For me the lap was cake and doing so saved me from two months of Lupron and an unneeded IVF cycle. I’m not saying IVF isn’t the solution for you, it’s just often that endometriosis often presents itself as unexplained infertility and I’m sure you and your doctor would want to know if you have before IVF begins. Hope you don’t hate me for the unsolicited advice! I wish you the best of luck and will be following your progress!

  4. I had an HSG more than a year ago, and a hysteroscopy a year ago (where they visually inspect the inside of the uterus with a little camera; it was during my lap, so I was completely knocked out). I’m schedule to have the SHG next week, prior to the start of my IVF cycle. I knew that the HSG wouldn’t give much info about the uterus; they told me it was all about the tubes, but that they might be able to detect larger polyps. I’m comforted by the fact that my hysteroscopy showed no physical problems, but that was a year ago, so it’s possible things have changed.

    • Thanks so much for chiming in. It does seem like the SHG is better at visualizing inside, though nothing beats the lap. I am wondering if endo can be seen during the hysteroscopy I now have scheduled…hmm. Because if not a lap might be a good thing to add since Ill be under already.

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