I was dreading doing the follow-up HSG test, mostly because of how painful the first one was. But there was no way around it, I had to have this HSG test to determine if my last surgery cleared all my uterine scarring. If any scarring remains that would mean I can’t move forward with IVF. So a lot was riding on this HSG test.

 

 

Post-Surgery Follow-up Appointments (HSG Test & Ultrasound)

I was praying this follow-up HSG test would not be as painful as the first one, but I really had no idea what to expect this second time around. I’ve heard from other women on the Asherman’s Syndrome forums that as long as you had a successful surgery and uterine scarring was properly removed, your pain level should be less with the second HSG test.

For this second HSG I openly talked with the nurse and doctor about how nervous I was, which I think helped because they were able to talk me through it. There was some pain, but it was brief, only for a few seconds. I’d say the level of pain this time was 4 out of 10 when she was putting in the catheter. I was so scared that that level of pain would increase that my  anxiety started to go up.

I was so nervous about the process and remembered how painful the first HSG test was. My nerves now had me saying out loud, “I don’t think I can do this.” The doctor paused and asked me, “tell me what’s going on, what is the pain like? Is it like a pinching, a pressure, or cramping?” I thought about it for a few seconds, but then I realized that I wasn’t experiencing pain, it was pure anxiety. I’m glad she asked me questions about what the pain was like, because it made me realize it wasn’t pain, it was just anxiety. I told her that it wasn’t bad and that we could continue. I was able to complete the HSG test, feeling a bit rattled by my nerves but thankful I didn’t chicken out. So in the end, this second HSG test was in fact significantly less painful for me.

The radiologist seemed to think there was something on the ultrasound indicating scar tissue remaining, yet my nurse (calling on behalf of my doctor) said the exact opposite a few days later. She read the report to me, deciphering the medical jargon and said that the flow of the dye in my uterus indicates everything is clear and functioning correctly. I still plan to ask the doctor in New York (at my future IVF clinic) what he thinks. But it sounds like things are looking good and I am cleared to do IVF. Yay! Oh but wait, now I have to decide when to do IVF while COVID is going on.

 

Navigating Fertility Treatment During COVID-19

I decided to sit down with my husband and brainstorm our options for what we should do next, now that my scarring has been removed. In the past, my doctor said my best option was IVF, but that was before anyone knew about my septate uterus. Now that my septate uterus has been surgically corrected my odds of a successful pregnancy have gone up. “After surgery, between fifty to eighty percent of women with a history of recurrent miscarriage will go on to have a healthy future pregnancy” (Healthline, 2018). Pretty amazing right?

“So why don’t you try to conceive naturally again?” you may ask me. But I have a history of having Trisomy 15 and 16 miscarriages, indicative of an egg issue, not a uterus issue. My doctor in California believes that there are most likely multiple issues going on with me, including my septate uterus and my eggs most likely. Thankfully he fixed two issues, the uterine scarring and the septate uterus. But the egg issue is much more complicated. After asking multiple doctors the question “What is the best way for me to have a healthy baby with reduced risk of another miscarriage?” they all said, “IVF.” I’ve asked three different doctors this question, and they all explain their reasoning relating to my egg quality.

I told my husband, “The amount of money I’ve spent on four corrective surgeries after my last miscarriage from conceiving naturally, equals what we could have paid toward IVF instead.” Just looking at the numbers and my past history shows that IVF would actually be my best option, physically, emotionally, and financially. It just makes sense for us. But there are two hurdles left to deal with before we do IVF again, the money needed for IVF and now COVID.

At the moment I am considering holding off on pursuing IVF until I get the COVID vaccine, which seems to be anywhere from 3-6 months from now. I know my biological clock is ticking, but it’s so risky to travel right now for treatment. I think I can wait a few more months. Plus that will give me time to figure out funding IVF treatment, which will mostly likely include getting another job. Hopefully I can get a second job, it’s hard to say in this economy, we will see. 

I still have my initial phone consultation with my new RE in New York. I think he will understand me postponing treatment for a bit, but I still want to hear what I can do in the meantime to prepare for treatment. I want to make sure all my ducks are in a row before I do IVF again. There’s the administrative ducks; medical history, insurance information, and ROIs. Then the physical ducks; a food plan for fertility, exercising, and supplements. Then of course the financial ducks. These are not all of the ducks that need to be in a row, but you get the idea. There’s a lot of moving parts to doing IVF. I’m hoping this upcoming consultation will get me going in the right direction at least. 

 

MRI Results

So a few posts back I talked about how I found a lump in my breast. I found out recently that thankfully my mammogram and MRI show that it is not cancer. My doctor said, “We should still remove it, or at least do a biopsy, but it would be better to just remove it completely.” After careful thought and about a month to think it over, I decided to not do the biopsy or lumpectomy, at least not right now. I based my decision on the fact that the mammogram and MRI show no cancer as well as when my doctor said that the odds of it being cancer are less than 1%. If it’s less than 1% then why would I have surgery? I suppose she wants to be cautious and remove it out of an abundance of caution since I have a family history of breast cancer. 

I’ve been on and off fertility medication a decent amount of this year, so that too could be contributing to the size of this lump. So I decided to continue monitoring the lump over these next few months. If it’s still hanging around, I will get a second opinion before I decide to do a biopsy or lumpectomy.