Hysterectomy or HSG


#1

Can I get opinions from those who’ve had failed IVF and can’t try anymore? We we’re trying for a sibling and for the first time got a :bfn: after making it all the way to transfer with 2 great embryos. We can’t afford to continue IVF and with my AMH so low (0.2 almost a year ago), and FSH 16 at last check, we were lucky to get 3 eggs this time. I had planned on a hysterectomy if we couldn’t get pregnant again because of endometriosis and significant pain at times. We’ve never gotten pregnant naturally or with IUI, so I hadn’t seen the point in just trying naturally for a few years again. But I’ve never had an HSG to verify that my tubes are in fact blocked, my RE just assumed since we’ve had as many as 4 follies at trigger with IUI before and gotten :bfn: During 1 of my 2 laps to clear scar tissue, my GYN at the time said he flushed my tubes and did see fluid “trickle” out of them. I’m just wondering if I should do a HSG to see the true state of the anatomy before I go removing my uterus. Has anyone’s RE “assumed” tubes were blocked and never done a HSG to make sure? How expensive is HSG? Just trying to make a decision on where to go from here. I also have to consider the fact that I have very low ovarian reserve (last AFC before this IVF was 2). So even with clear tubes a natural :bfp: is unlikely. I am hesitant to officially say I’m thinking about TTC naturally for a while cause we all know what heartbreak and disappointment goes along with that from month to month and I’m not sure I want to go through all of that again. But I also don’t want to completely eliminate any chance at a natural miracle.:flower:


#2

The HSG and clomid challenge test were the first two test, besides bloodwork my RE had me do before being able to even start any kind of treatment. i think my RE was testing for everything to make sure it was just more age related. But if your RE had copies of your medical record from you OB they may have felt they didn’t need to do an HSG. I had an HSG done and it helped clear out the tubes. The month I had it done I had also did the CCT test and got pregnant, but miscarried. My AMH was higher than yours was 0.7 at the time, but I was also older than you so more chance of egg issues. My issuance paid for the HSG so I am not sure how much it would cost. If you have issuance you can have your OB order them it may not be coded as infertility test. My RE did say that there is a increase in the chance of natural pregnancy after the HSG, I think since the tubes are basically flushed out. I do not have endometriosis so I can’t really give you any information regarding that part.
I have seen on this board that there are some with AMH same as your that get a natural :bfp: during IVF break. So it may be worth trying the HSG. It may give you peace of mind and help you make the decision without having any what ifs later down road.


#3

The hsg with my RE is $275 oop. If my Obgyn refers me to a radiology center my insurance would pay for the procedure, copay only.


#4

I’m just thinking it would probably be cheaper to do it through the RE. I’ll have to price it out. My insurance only kicks in once my deductible is met and being a new year that’s not the case. I’m wondering if it would be cheaper at my RE since it’s an “all-in-one” situation as opposed to a radiology center that may bill for the doctor, the procedure, etc. all separately.


#5

First, I love your quote in your signature. Need to jot that down myself. Our ttc journey is also over. We tried 3x for a sibling and have chosen to give it our all to our miracle dd rather than be consumed with chasing after a sibling.

My RE also required me to have an HSG before our first IVF. I did mention to him though that a lap early on in our ttc history revealed one of my tubes blocked. He ordered the HSG to ensure both tubes were still open (they were) and that I had no hydros that would interfere with implanation. If you told your RE that your GYN mentioned fluid trickled out, he may think that’s enough to know they’re open.

Of course there’s a little bit of unknown with the word “trickled” if that in fact means completely open or partially blocked. It might be worth it to call either RE or GYN and explain you would like to continue ttc naturally but need to know if your tubes are open, exactly what does that report say?

I’ll never give up on conceiving naturally. We try every month. But, I’ve also gone on living life and am no longer consumed by the need to have another baby so that every month I’m in tears (btw, it took a while to get to this place). I do know of some who are ready to end the insanity of hope and will get a hysterectomy. Personal decision…

Sorry for you last BFN. Been there and it is so hard.


#6

Just reread your siggy…so sorry for your lost angel. I cannot imagine the grief. Hugs to you…


#7

Thanks for your post Cali. It is good to know that there’s a place past infertility that you can still TTC each month without being consumed by it. I know that place exists, that’s where I feel we’ve been for the past few years since DD was born. We’ve been in that “we’re not “not” trying” phase. But I think it felt easier cause I knew IVF was still an option in the future again. But we’ve exhausted that option at this point. So I’d love to get back to that point of “if it happens, it happens”. And I’m back to enjoying my DD everyday more and more again since our BFN. It’s hard to stay sad for too long with a true miracle right in front of me. I had posted this question before even bringing it up to DH cause I wanted to get a feel for if it was something I really wanted to do. So I brought it up to him yesterday and I was so relieved when he said, “I never asked you to get rid of your uterus”, lol. He’s very supportive of doing the HSG and then seeing what happens naturally over the next 5 years or so. I know I’ll probably be menopausal at that point, lol, but I always hear about people getting natural BFP out of the blue a few years after “giving up”. I just want to know if my tubes are even open that it’s a possibility. I don’t want to hang onto false hope if they are blocked. My records from that lap say that my tubes are “patent”. But I remember him telling me that the fluid “trickled” out of the tubes. And my RE says “trickling” is a bad sign. I think it will just answer a lot of questions about how much of my problem is really scarring from endo and how much is just low ovarian reserve. I really think my tubes are blocked. I don’t know if this sounds weird but I swear I feel like every month when I ovulate my body is doing everything right. CM is excellent, I literally feel “fertile” but nothing ever happens. Another issue could be the tubes just not grabbing the eggs. I told DH yesterday that if we find they are open, even if there are a lot of other factors working against us, why not just give it some time to see if we can be those people that just have a really lucky month where everything just lines up perfectly. I’ve never had a natural BFP so it’s kind of a little dream of mine to just be one of those people, “Hmmm I’m late, oh look at that, I’m 2 months pregnant!”:pray:


#8

I am the same way. Every month, I O perfectly. I have the perfect CM and like you just feel fertile, yet nothing ever happens. About 7 yrs ago we did have a natural pg but I m/c very early on (5 wks maybe). And that was when I had only 1 tube open, I learned later. We have literally ttc for going on 12 yrs. No explanation at all for our IF, though we never did karyotyping or testing like NK cells.

I’ve been on various IVF and IF boards for several years now and I have seen many times women with very low ovarian reserve who have been told they would need donor eggs, go on to have a surprise pg. As one person told me not long ago, if your tubes are open all you need is some sperm and your uterus and the possibility is always there. Hope we both get that miracle pg!

Feel free to PM if you go through a rough patch and need a shoulder to lean on. I’m a little ahead of you on the grieving process you go through when you finally throw in the towel and call it quits with the RE. Just remember, focus on the miracle in front of you, just like you said.