Do I need HyCoSy (with history of chemical pregnancies)?

[Mrsspoon3]

Hello! I just wondered if anyone had any experience/knowledge of this please ...

I’m looking to get some more tests done to check my fertility (have had all blood tests and waiting on a normal ultrasound) and wondering about the HyCoSy or other scans that are done to check if tubes are blocked.

As I have had 2 chemical pregnancies (within 5 months of ttc) I just wondered whether it was necessary to get this test? As I have been able to get pregnant does this mean at least one of my tubes are open, or could it be possible I had 2 ectopic pregnancies that showed up as positive on my tests and tubes could still be blocked?

I can’t get to actually speak to a doctor due to Covid to ask these questions, though hopefully will at some point, but just wondered whether anyone had any knowledge of this in the meantime? Would really appreciate it!

[Chanel05]

A doctor won't see you until you've been ttc for 12 month if under 35.

I'd really just hold off on anything like that yet. It is very normal to take up to a year to conceive and unfortunately, that year clock starts again if you have a loss.

My advice would be to hold off testing until you've missed a period.

[firsttimemummy321]

@Mrsspoon3
I'm sorry for your losses 💕
Are you getting these tests privately? @Chanel05 is right that usually a dr won't investigate until you've been trying for over 12 months or had 3 miscarriages. (I've just had my 5th and decided it was time to speak to my dr about a referral)

I suppose you can't rule out that they were ectopic but at this stage with no history of ectopic or other risk factors? I'd assume they were normal chemical pregnancies as they self resolved.

If you're going private that dr should suggest it if they feel it would be of benefit. With regards to speaking to your dr I understand at the moment it is difficult to get a face to face appointment but you can usually get a telephone one same day so might be worth trying that if you're concerned (although bear in mind at this stage it's unlikely they would be able to request any investigations.

With one or 2 chemical pregnancies I was told to see the positive that we could get pregnant, apparently 25% of pregnancies go this way due to the embryo not being viable (chromosomal abnormality) and you will go on to have a healthy pregnant in the future. I had one a few years again and then conceived our first who is now awake wanting to play 🙈

Good luck x

[Mrsspoon3]

Thanks so much for your replies!!

I’m 36 which is why I’m looking at tests now, as worried about wasting precious time! I’ve contacted my GP a few times and they haven’t given me a phone call but were happy to start tests now. They’ve done lots of blood tests and referred me for a scan on NHS but there’s a 12 week wait so I’m contemplating going private. That’s why I’m trying to assess whether a scan of my tubes is necessary or not as trying to figure out whether I can afford private as this is a lot more expensive if needed! I’m just trying to figure out what I might need before starting down this route and this was the one I was really unsure about due to having got pregnant, if that showed my tubes were open or whether they could still be blocked.

It’s totally not that I have written off being able to conceive after only 5 months or anything (though feeling increasingly disheartened!) just that given my age and that I want a baby more than anything I just want to know now if there’s anything stopping us that could be resolved before my time runs out!

So glad to hear you were able to conceive after your chemical pregnancies firsttimemummy!! 😊

[ZingDramaQueenOfSheeba]

oops, posted on wrong thread.
sorry.
have asked to get it deleted.

[firsttimemummy321]

@Mrsspoon3 glad they're testing at least you will have answers and hopefully all is fine :)
You mentioned about if your tubes might 'still' be blocked. Were they blocked before? If they were I'd suggest it's worrh checking but if not for now if I was you I would assume they are not but if you wanted a full mot could get them checked anyway? X

[Mrsspoon3]

Thank you! Oh no sorry, bad phrasing, I just meant even after having got pregnant could that still be a possibility. They weren’t blocked before (that I know of)! Thanks so much for your message and advice, really appreciate it! x

[choccrumpet]

@Mrsspoon3 I'm sorry for your losses. I've had about 5 chemical pregnancies in 9 months of trying. I'm 28 with no previous children. My GP referred me for investigations after my 3rd and I had my first appointment over 4 months later. I'm about to start some tests that I believe are common to all or most referrals, one of which is a HyCoSy. I don't believe the tests I'm having done now are specific to me because the nurse didn't have access to my info during my appointment, I'm not sure if she had a referral letter or any other info but we didn't discuss my chemicals during the call. I mentioned I had a bicornuate uterus and she said I'll probably have testing to check it out and potential surgery but she needs to see my info first, I hope she'll have access to it by my next appointment after I get these bloods done.

So what I'm saying is that HyCoSy seems like a standard procedure done during these types of investigations, not necessarily because of my chemicals (I could be wrong of course). It's worth trying getting a referral from your GP or going private if you choose to go that way.

[Mrsspoon3]

Thanks so much choccrumpet, I’m so sorry to hear about your losses also! That’s great you’re getting tests done now, hopefully that will help you with getting pregnant very soon!
Can I just ask if you don’t mind what tests you are getting done? I’m just wondering what tests are normal and what I still need done.
I will definitely get the HyCoSy if needed, I was just wondering about it as I think a referral for that will take a long while and I would struggle to pay for it privately, so was wondering how necessary it would be if I had got pregnant before (with chemicals, I’ve never had a full pregnancy). But will hopefully be able to find out more if I go for a private consultation.
Thanks so much for your message!

[choccrumpet]

@Mrsspoon3 for now they've asked me to do cd1-4 blood testing for LH, FSH, AMH, prolactin, TSH, rubella and day 21 progesterone blood but as I ovulate late I've got day 21,28 and 35 to make sure we get the right days. Then a urine test for chlamydia and once that's negative they'll do my HyCoSy. My partner is having a semen analysis. And I assume there'll be more after these are done that are more specific to me if we're not pregnant by then.

I don't know what tests are normal, I'm doing what they tell me! I've seen a glimpse of what these might cost privately and it is a lot. If you can get a referral now at least you can have that going whilst you look for other options, you might get an appointment sooner than they predict. Like I said I'm not sure if this is all I need or don't need due to my chemicals which is a bit frustrating BUT I'm happy to have the ball rolling and hopefully getting some answers.

There's a few threads about fertility investigations, they might give you more info. I haven't done much research myself on this as I wasn't expecting my appointment to come when it did, I thought it would take a lot longer so wasn't depending on it. I'm on cd9 in this cycle so waiting until the next one to start the bloods. I've also started acupuncture which is helping me mentally (and hopefully physically), if you are able to afford it I would recommend trying it out to see if it helps you.

[willithappen]

I'm not 100% but I'd imagine if you are getting chemicals at least then tubes are likely open as otherwise the egg wouldn't get out to fertilise? I don't know the workings though

I have had a HyCoSy as part of IVF investigations. All we had was day 21 bloods, partner had an SA and then we were offered the option of going straight to ivf or having a HyCoSy. It had been 6 years of not even a hint at BFP so I wanted my tubes checked and got it done. Was told one was open and one was 'more than likely open'
We went on to ivf and I'm now 7 weeks :) also 28 years old

[Mrsspoon3]

Thanks so much for your replies!
Everyone I know got pregnant so quickly and didn’t have tests so it’s not something I know anything about, and as I’m unable to actually have a conversation with my GP I’m having to research everything myself, so it’s super helpful to hear from others!!

I had all the same tests as you @choccrumpet (except for AMH and rubella) so that’s reassuring! That’s good you were able to get your tests quicker than you thought. Great to hear the acupuncture is helping too!

@willithappen That’s what I was thinking about tubes being open, but didn’t know if that was correct! Congratulations on your pregnancy!! You must be thrilled! So glad it all worked out for you!

[Twizbe]

I had a 2+ year infertility journey and had loads of tests but no chemical pregnancies.

They didn't do that test for me. I had a lot of ultrasounds and they all seemed to think the tubes were clear so never ordered it. This was both the NHS and private doctor we saw.

If the NHS are testing you, don't waste your money on private tests. Honestly, it was such a waste for us. They found nothing the NHS didn't and the waits were the waits. We had unexplained infertility so whether we'd waiting 12 days or 12 weeks the tests would have still come back fine.

2 chemicals in 5 months of trying suggests that something is working. I think early miscarriages are very common but many women mistake them for a normal period. Fingers crossed the next one is sticky

[Mrsspoon3]

@Twizbe I’m sorry to hear you had a long infertility journey.
That’s really helpful to read about your experience, thank you! That’s good the normal ultrasound can indicate if there might be a problem with tubes.
Thank you so much, really hope the next one sticks! Definitely going to give up early testing for one thing so as not to get my hopes up!

[Elouera]

Sorry for your losses OP. I agree with getting the ball rolling after 35 and yes, NHS waiting times can seem to drag on. Do look around price wise if you go private. Some larger hospital that have a fertility clinic will also see you privately, and they can often be cheaper than say a stand-alone private clinic. My understanding is that HCG and Hycosy are very similar, but the hycosy doesn't use radiation. Its under ultrasound instead, which IMO seems safer, as less exposure to radiation seems a good thing- esp when TTC!

The hycosy doesn't just check tube patency. It looks at the structure and shape of the uterus too, so can see things like fibroids, polyps and abnormalities with the uterine lining. An ultrasound only looks a 2D, whereas the hycosy is 3D. Have they ever seen fibroids on an ultrasounds. They are more common as we get older, higher BMI and higher in some ethnicities. If the fertilized egg cannot implant, that can be a reason for early MC/chemicals. Maybe you are getting pregnant quickly, but there is an issue with your lining, or structures impeding implantation.

Its one of several test usually done as part of an infertility work up- STI check, AMH, semen analysis being some others. How long is the NHS wait in your area?

[Mrsspoon3]

@Elouera Thank you.
That’s a good tip about looking at hospitals that also do private appointments, thank you!

Ah ok that sounds like the HyCoSy could be helpful then if it looks at so many things! I guess I was just hoping I didn’t need it as in that case (having had all blood tests) the only thing I’d really be waiting on is the ultrasound, which is reassuring as cuts down on waiting times if I go with NHS and costs if I go private. Also if I’m honest I’m a little freaked out at the thought of it as it’s more invasive than other tests!

I had a normal ultrasound 2 years ago as part of tests for PCOS (which I was told I didn’t have) and I wasn’t told I had fibroids, but I guess they might not show up on that or could develop since. It does sound like the HyCoSy could be helpful though (despite my reservations!) if it could show why we keep having chemical pregnancies.

I guess there might be other tests too I don’t know about! Seems like there’s loads! The only thing I’m currently waiting on is the ultrasound, which they said would be 12 weeks, so if I need anything else the wait is going to be super long as they just seem to schedule one thing at a time rather than letting me book for a few things. My husband’s GP surgery is awful too and I’ve contacted them twice online about the semen analysis (as it’s the only way you can get in touch during covid) and not had any reply. Just feel so stressed with the whole thing which is what is making me consider going private!

[Elouera]

@Mrsspoon3- I completely understand the frustrations. I started TTC age 32. 11yrs on and 3 MCs, 2 rounds of IVF later, I'm still TTC. One thing to note, is that a cause for infertility isn't always found.

Have you had an AMH blood test and scan done to check your egg reserve? This will give you an idea as to whether your egg reserve is high, low or average for your age. In my case, mine is great for my age, but seems my egg quality is likely a cause for the MC's. This 'might' be the same for you, in that genetic issues might be causing the chemicals.

In terms of HyCoSy, I personally found it painfree. I know others found it uncomfortable or even painful, but it wasn't for me. My tubes were clear though. I've honestly had worst smear tests- and most of those have been fine too! From memory, I took 2 paracetamol beforehand, they explained it all and it was fairly quick. The worst part was when the liquid they injected ran out all down my bum and tickled!!!! I certainly didn't expect that!

I'd suggest buying a book called 'It starts with an egg' by Rebecca Fett. I just got a 2nd hand copy from ebay. Check its the 2nd edition, which I believe is the latest. Worth a read and has some tips on reducing chemicals and every day things which could be contributing to the losses.

Sorry that I've written such a huge response again, but if you do have questions, feel free to ask x

[Mrsspoon3]

@Elouera Ah thanks so much for taking the time to write such a detailed response, I really appreciate it!! You don’t have to apologise for a huge response at all, it was so kind of you! And mine is super long too haha, sorry.

I’m so sorry to hear you’ve had such a long journey of TTC and are still on it. It must be so heartbreaking and frustrating for you! Have they found any reasons for it or have all tests been fine? Are they just guessing it may be down to egg quality or was that found on tests? I really hope you get a BFP soon! Are you waiting on another round of IVF?

I’ve not had an AMH blood test yet as it wasn’t offered in my tests by the GP. I saw it was one of the ones listed at a private clinic I was looking at but I’m not sure if I want it or not. It may be just a case of burying my head in the sand but as there’s nothing that can be done to increase egg reserve it might just be another source of anxiety I think if it turns out to be low! I had my FSH test done (which I know also tests egg reserve though not as accurately) and it was 7.9, which I was really sad about as I read that for 35-37 year olds it should be under 7.9 and I’m 36. I know that’s borderline and still fertile so sounds silly, but that’s the one thing I was counting on being good as I didn’t start my period until I was 19 so my GP said that should mean I had more eggs left than usual! But apparently not. So I think I’d rather not know the AMH, especially as I don’t think I want to do IVF, which I know it is needed for. I know that probably sounds really silly!!

I did wonder if it might be egg quality though and just got some ubiquinol to try as I read that can be good. Have you tried it?

Thanks also for suggesting the book! That sounds really helpful! Will definitely give it a read x

[Elouera]

To answer your questions, no, I haven't had any specific cause for sub-fertility. I do have some small fibroids, but was told they weren't blocking the tubes or preventing implantation etc. My 1st pregnancy had trisomy 13 (found on NIPT at 10 weeks) and the 3rd pregnancy had monosomy 21, unsure about the 2nd MC in between, but most likely caused by a genetic issue also. Even though my egg count is good, it points to the quality being poor from my older eggs.

Its worth checking the IVF requirements in your area- even if you don't plan to go down that route currently. I was always of the opinion that it will happen some day and also never considered IVF. It wasn't till I'd already got to 40, after my 2nd MC and multiple GP delays in referring me, that I actually thought about having it. My area allows 3 NHS tries up to age 40, then only 1 after age 40. Other areas don't allow any at all. Some areas have requirements like BMI, AMH, smoking etc. I may have a 3rd and final go at IVF, but have been told my chances are slim and to think about egg donation.

I'm unsure how starting menstruation so late affects things, but you only release 12 eggs a year normally, so yes, you will likely have more eggs than someone that started menstruating age 12, but realistically, that is only 84 more! I was told to ask when your mum started menopause and this can give a very rough guide of how many more fertile years you 'might' have left.

Yes, I take ubiquinol. I'd read alot about it before starting.
Apparently if the packet has kaneka on it, the active ingredient is absorbed easier/better. Something to do with it being oil soluble. I get mine from ebay. NUYU brand, 200mg as it seemed the best value for a good dose size.

I also started DH on a multivitamin with lycopene. I'd read that it can help sperm quality and motility. His results were 1 point off normal, but the Dr said it was likely due to him having a cold the week before.
I thought it couldn't hurt. Lycopene is found naturally in tomatoes and other red fruit/vegetables. I found several studies about the benefits, but very little info on what dose he should have. I got 50mg a day in the end.

I asked the fertility specialist about supplements, ubiquinol etc. He said there is limited data, but if they aren't overly expensive, they couldn't hurt. I've seen some companies selling them (Zita west being one) but the vitamins were much more expensive that you can buy elsewhere and I couldn't see any benefit to paying much more for the same dose!

Another thing to look at is lifestyle. When I was initially TTC, I had a very stressful job, travelling alot for work etc. I was off the pill, but TTC was down my list of priorities and I was sometimes away during my fertile time. I left my job, DH and I both lost 10kg and I conceived the following month. I'd been TTC 4yrs at that point! I was only a few kgs above a healthy weight range, so no idea if it was the weight loss or reduced stress which helped. Unfortunately, that was the T13 pregnancy, but at least I knew I could actually conceive!

Are you waiting for the gynae/fertility specialist appointment now?

[Juno231]

@Elouera sorry to butt in but wondering if in your case the clinics will have done DNA frag on OH and NK cells for you? The genetic problems with the embryos can be jusy as much him as you surely?

[Elouera]

@Juno231- I don't recall either of those tests being done. We both had genetic tests to check the genetic issue wasn't a translocation and that we weren't carriers though.

After the 3rd loss, I was told I was referred to the recurrent MC clinic and even saw the nurse completing the form in front of me. I was hoping to finally have killer cells and other tests done. After 6 months of waiting (early covid so assumed that was the delay) I got in touch with them again. I was told that because my first loss was TFMR, rather than strictly MC (despite the T13) that I didn't qualify for the recurrent MC clinic. If they'd bothered to tell me this, I would have had those tests privately a year ago!

This is just yet another delay I've had over the years in getting anything checked. Fobbed off by GP initially and told to relax! Next told I was 2 weeks off the required time for TTC before they will do any checks. Finally had day 21 blood checked and because it was normal, nothing further done and no referral made!

In hindsight, I wish I'd made TTC my priority a long time ago and not my job. I know FAR more now about normal timelines and what tests should have been done. I wish I'd pushed earlier for referrals and tests and gone private earlier for some tests too. Unfortunately, I'm now unlikely to ever have my own child with my eggs. I have a happy life and fantastic DH so we might get a dog!

[Mrsspoon3]

@Elouera thanks for your message!
Thanks, it’s not that I’m not considering IVF because I think I will get naturally as I’ve always thought I would struggle for some reason, and more so since I only met my husband when I was a bit older. I’m actually really convinced we won’t get pregnant naturally, though hope I will be proven wrong!! It’s a hard decision as I am absolutely desperate to be a mum, but I discussed with my husband and think we will adopt if we don’t get pregnant after 2 years trying on our own, as I suffer from extreme anxiety and am super emotional always, so I think having to take all those hormones and then the anxiety of waiting to see if the IVF works would be too much for me. I don’t think I could handle it unfortunately so think adoption is probably a better option if trying on our own fails.
I’m really sorry to hear you have been told your chances are slim with more IVF. That must be so hard. I really hope you find something that works for you.

That really helpful about the supplements, thank you! We both eat really healthy and have a normal BMI (he’s a lot slimmer than me haha) and are very active, but I’m worried about my stress (which is crazy levels all the time) and how that could affect things, and am also keen on getting his sperm analysis as I think he could stand to drink less alcohol to give us our best chance, though he disagrees!

No they’ve not referred to a specialist or anyone. The GP just emailed me the form to book blood tests, then when they were back emailed me a link to book for an ultrasound! I guess they might refer me to someone after that but it seems a long wait when the ultrasound is already 12 weeks away! I’ve not had a single conversation or consultation with anyone or been referred for one either, despite expressing my concerns to the GP, which is why I’m thinking it might be best to go private now given my age and I don’t have time to waste.

[CPsRus]

I have recurrent chemicals (5 in 12 months plus one early mc). I am currently being tested privately and waiting on my results (more in depth stuff now on nks mthfr, thrombophilia etc) but in the meantime I am reading this book and I highly recommend it!

www.amazon.co.uk/Your-Body-Baby-Friendly-Unexplained-Infertility/dp/0978507800?tag=mumsnet&ascsubtag=mnforum-21

[Juno231]

@Elouera thank you for your response. I know what you mean - I see lots of ladies on here constantly being fobbed off by doctors and the NHS and sometimes I just want to shake them into action as I know all these things can take ages even if not fobbed off!

[Mrsspoon3]

@CPsRus So sorry to hear about your losses. I hope you get some answers soon and the next one sticks.
There are so many more things to test than I knew existed!!
Thanks so much for your message and the book recommendation! Will check it out.