Hysterosalpingogram advice

[Geep]

Hi,

I have to arrange to have a hysterosalpingogram next month. Just wondering what to expect? Have read it can be painful if tubes are blocked?

I've been advised that if my tubes are blocked then they will need to be removed before I can try another cycle. Really hoping this isn't the case but if it is, anyone know how long after having tubes removed I can start an ivf cycle?

Thanks

I've had it done twice and didn't find it anymore painful than a smear test but both times neither tube was blocked

However I have also had both tubes removed as despite them not being blocked I ended up having ectopic pregnancies anyway

After I lost my last tube in the July I then had a round of IVF in the September so about 8 weeks between operation and starting IVF but I did short protocol IVF which only takes 2 weeks to complete rather than long protocol which is 6-8 weeks

Hi @Geep how are you doing? I’ve had a few different tests since we last chatted on here including a HSG, I was having a medicated mock FET with a biopsy for ERA EMMA ALICE, there were lining issues during the biopsy and my specialist mentioned Ashermans syndrome. So I spoke with Mr Trew who is an expert in the condition and he arranged the HSG. I had it the week before last. It wasn’t comfortable, but none of these procedures that we have are, I didn’t find it painful though. They put in a speculum and then put the dye up, it can take around 20 mins while they try to get the images they need. My uterus looked fine and tubes were clear. I’m not sure what it would be like if that wasn’t the case though. In my case I was told it was normal and the next day the biopsy results showed there were significant issues with my microflora, so I’m on antibiotics now and then will be on probiotics.

Hi,

@andivfmakes3 Do you mind me asking how many ectopic you had before they removed your tubes? It is suspected I have had 2 very early eptopic pregnancies. During my recent attendances to the EPU they saw something in one tube which they think is from the loss a year ago, then could see something in the other tube from the current miscarriage. So being referred for HSG to confirm what is going on. However my clinic has said that often the tubes are OK and don't need removed. That's good you didn't have to wait long between the surgery and a new cycle. I'm finding the waiting the hardest bit. We've been ttc for over 2 years and have been told to not try until we get these tests done.

Hi @Gardenlady543. How are you? That's good that your uterus and tubes are OK. I guess its one more thing checked of the list of possible reasons. You said significant issues with your microflora? What does this mean in relation to fertility treatment? What's the next step for you now? I'm in a bit of a slump at the moment. Annoyed that I can't try anything and feel like I've wasted 6 months (I'm already 36 so time is not on my side). Obviously I know it's better to get as much checked out before having a other cycle as it will all help our chances of a positive outcome but still hate the waiting. I'm Just hoping whatever they saw in the tubes isn't blocking them and i can try again as I'm don't want to think about how long I'd have to wait to get them removed of they need it.

Bless you @Geep I think it's so hard knowing there is potentially something there and had it been found sooner, we may not have had to go through what we've been through. It sounds like the HSG is a good idea in your case, it's crazy that people start IVF without looking for structural issues, there are lots of things that the US won't pick up. I know you've had a couple of miscarriages so it sounds like a very good idea to get the HSG.

The EMMA looks for the levels of good bacteria (lactobacillus) and dysbiotic bacteria in the uterus. The ALICE looks for the bacteria that causes chronic endometritis. I didn't have the chronic endometritis bacteria. However I had 0.00% lactobacillus, which is shocking.

This study https://doi.org/10.1016/j.ajog.2016.09.075 separated women with more than 90% lactobacillus vs those with less than 90% lactobacillus, the outcomes were statistically significant:
Implantation 60.7% vs 23.1%
Pregnancy 70.6% vs 33.3%
Ongoing pregnancy 58.8% vs 13.3%
Live birth 58.8% vs 6.7%

I was prescribed a week of antibiotics and then told to take vaginal probiotics for 10 days. It's likely when I had a coil put in that it took the dysbiotic bacteria up there and since I've not been on antibiotics for many years it just flourished.