Hi STT,
Was just browsing this topic and felt I had to respond.
First of all you poor thing....it is an absolute shock to discover fertility is going to be a challenge. When you've always been healthy it is not something that you anticipate.
I had tubal problems and experienced 3 years of TTC. It started with an natural and instant conception which ended with m/c at 6 weeks. Then nothing for 3 years other than suspected early implantation and loss based on symptoms only. I was diagnosed with a tubal problem 14 months post m/c after the HSG. My HSG absolutely murdered too. It was worse than any other pain I'd known. My goodness what an awful shock it was to find out I had tubal problems too.
They questioned if I had a hydrosalpinx on the right which is a blocked and swollen tube. Unfortunately this makes the tube ineffective even with surgery and the usual route is removal and if both tubes are blocked this then means IVF to conceive. Often hydrosalpinges follow a STD or pelvic infection. I was baffled as I had neither in my past. I was advised to proceed to IVF which failed despite making excellent embryos. I had 1 full cycle and 2 frozen embryo cycles which was a shock to the Dr's as I looked to be a strong candidate. I was 31 / 32 at the time.
There had always been this black cloud hanging over me about my right tube. Some Dr's thought it was a small and insignificant blockage, others advised me to have both tubes out, it frightened the hell out of me.
I then went on to have a lap - what I should have been advised to do in the first place. They found that my right tube was sealed down to my bowel from the fimbrial end with filmy adhesions - most probably endometriosis was the cause. I had no symptoms. So the right tube was never able to pick up an egg and probably the left tube was but each fertilised embryo going down the left side was probably washed away with toxic fluid.
When a fallopian tube is fully blocked there is no where for the natural fluids inside to drain to, so they stagnate and swell up the tube. In a tube which is partially blocked, as in my case, as the end was tethered down the natural tubal fluids were pooling, becoming toxic and then washing down in to the womb from the right tube. This meant any embryos which had left tube became washed away and I was never ever going to get pregnant from IVF or naturally.
During my lap they snipped away the adhesions, burnt away other small endo deposits and the tubes sprang back to position the blue dye was seen to fill and spill.
I conceived my baby 2 cycles later naturally.
The above might not be exactly what is happening in your case but I felt so alone as there aren't lots of people out there with these subtle types of tubal problems. I wanted to share my experience and knowledge with you.
If having a hydrosalpinx (not likely) or a slightly blocked tube or perfectly intact tubes, I really recommend a lap before anything such as IVF to make sure IVF is or isn't needed.
However from an emotional point of view I recognise what you are saying about being exhausted and fed up. I remember in the earlier days of TTC feeling unnerved at low level things like fertility reflexology as I felt a failure for needing even that level of help. I actually thought I was living someone else's life by the time I went through HSG, IVF, laproscopy, not to mention countless dildocam etc.
My advice to you is sit back for a month or two. Sometimes no decision is the right decision (although don't remove yourself from any waiting lists etc). The enormity of it is hitting you and it needs to settle first of all.
I'd recommend a fertility acupuncturist or reflexologist as, although these won't always cure bigger fertility issues, placing yourself in the hands of a caring and knowledgeable person once or twice a month who will share your journey is priceless and very stress relieving. Also any hormonal imbalances can be addressed too - you mentioned some blood tests were a bit high. Do try and get more info about that.
In time, do consider that lap, it might reveal the very nature of the issue and treat it at the same time, or indeed rule our the tubes as problematic which allows you to focus your energy elsewhere.
I can't guarantee that anyone will get a baby....but being in your mid 30's puts you in a favourable position. And I hate to say it but sometimes it really is the absolute sheer determination to go through the fertility clinic mill which brings about the results too.
So first of all allow yourself some space to breath and let the tears flow and plan for nothing.
Then, think about IVF as the thing to try when other options do not as you have to wait a long time anyway. If you are still TTC by then I would put bets on that you would jump at the chance as your perspective might change. I found that I worried too much about the future but the future takes care of itself.
Give yourself an almighty pat on the back for the efforts you have put in so far. So many people couldn't do what you have done. Don't give up hope but be kind to yourself on the journey. Plan some fun nights with your DH, go to the cinema, don't stop having a bit of booze if that's what you fancy until you get a BFP, don't plan holidays around anything, embrace your life and enjoy it as pregnancies come around whether we are sat waiting or nt.
I hope you didn't mind my essay post, please feel free to ignore, I found it cathartic as my TTC journey was complex and hard.
By the way I'M ttc number 2 for 16 months and about to go on the waiting list for lap no. 2 hoping it works it magic again.