Fertility: HyCoSy

I’ve just got home after another trip to the fertility clinic this morning, this time for the dreaded “HyCoSy” procedure.

A HyCoSy is carried out in order to see if the Fallopian tubes are clear and healthy, or blocked. Blocked Fallopian tubes can mean that natural conception is not possible as the sperm and egg cannot meet.

I won’t lie, I’ve been dreading this procedure for weeks. I felt scared shitless by last night and cried when I got into bed from sheer panic and anxiety. Mainly from the pain to be totally honest but obviously what the results could mean for us. If my tubes are blocked that could mean we would never be able to conceive naturally and it would also mean that having IUI was out (which is our next treatment plan if necessary).

Anyway, it’s done now and I’m here to document what happened and how it felt.

The first thing that happened was that the dr collected us from the waiting room and asked me to read and sign a form (consent form I guess). He told me what he would be doing but I already knew in great detail because I’m an obsessive Google-er lol.

Once on the bed and in position, the doctor started by “cleaning” things up making sure everything was sterile etc. He then inserted the speculum (same as what is used during a smear test), he then inserted the catheter which goes through your vagina, through your cervix and into your uterus. I was nervous as hell about this as many years ago I had an IUD fitted and it hurt SO much. This was nowhere near as bad as that I swear.

Once the catheter was in place, a tiny balloon is blown up which holds the catheter in place. It’s absolutely tiny but I guess anything down there that’s foreign is going to feel big isn’t it??

I suddenly felt quite a bit of pain and I told the doctor and the nurse and the Dr said “is that better?” and it was – almost instantly. Apparently they blow the balloon up all the way, then they deflate it a little until it no longer hurts. I was relieved that this meant the speculum was in, the catheter was in AND the balloon was inflated. We were halfway there.

the next step is for them to insert the dye and that’s done via a syringe which is attached to the catheter. It felt uncomfortable, achy, but not painful as such. At the same time as the nurse is doing this, the doctor is using an internal probe/ultrasound to get a look at what’s going on. This is referred to as a “dildo camera” on the internet which is shockingly accurate LOL!!

The doctor was showing me my tubes on the screen and showing me the dye going through but to be honest, I couldn’t make anything out, it was just a blur but I nodded along anyway.

At one point the nurse did an ultrasound on my stomach but I don’t know why but my husband said it was to check the balloon was in the right place.

This went on about 15 mins and eventually he was happy and said we were done. I then realised that I had been clenching my bum LOL and so I tried to relax but my legs were shaking a bit and I guess it was just nerves.

Just as I relaxed and felt him remove the catheter, he inserted another speculum(wasn’t expecting that!) so was a bit of a shock but fine, just that horribly weird feeling when they screw it in place and then he must have cleaned everything up with some sort of solution as I felt very (excuse me for writing this) wet down below and felt like I was having a shower LOL! That was a bit cringe but I guess it’s nothing he doesn’t see all the time.

And then, we were done! Wahhhoooooo.

I got to get up and get dressed and then we went into the consultation room where he said my tubes were both absolutely fine and open. A huge relief.

He then told me that my anti tpo blood test results were back and were “normal”. I was glad but surprised and he said he was also surprised and said “it’s strange”. He said he would prescribe me with 50mg of thyroxine (for thyroid) and that I should take this for 4-6 weeks and get another blood test in 4 weeks to see if it’s helping to bring down my TSH levels which are too high.

And then we left!

I’m now laying on the sofa with a cup of tea. I feel so relieved that it’s over, relieved it wasn’t as painful as I was scared it would be and relieved my tubes are not blocked. I cried on the drive home when the relief hit me.

I have some stomach cramps but nothing bad at all, in all honestly I could be at work but I’m glad I’m not and I feel so tired, but I think that’s mainly to do with how anxious I’ve been feeling. The adrenaline is wearing off I suppose?

All in all, the HyCosy really isn’t bad at all. Certainly not as bad as I was worried it would be and nowhere near as bad as having a coil fitted. Not even close!!

I’m going to pick up my first thyroxine prescription shortly and I’ll start taking that tomorrow morning (an hour before food and only with water – no caffeine etc). My hope is that after having a flush out of my tubes plus starting thyroxine, that we have a better chance of conceiving naturally. Personally we have decided not to try this month (ovulation is a few days away) because we want my TSH levels to come down first.

Apparently your TSH levels should be between 0.5 and 2.0 when conceiving and my levels are currently at 6.0. This is important in pregnancy for fetal brain development and the baby’s nervous system so we are going to sit this month out and hope that next month I’m in a healthier place.

Fertility update

Yesterday I had another appointment at the clinic. It was a pretty big day for us yesterday and the first day we were going to get any actual answers about what is/could be causing us difficulties. After 3 years of not knowing anything, I was SO excited for this day to arrive.

As we drove there yesterday morning I started to feel a little sick with nerves. There were SO many possibilities about the news we could get. We could be told that our struggle was “unexplained” or we could be told there were serious problems. We could be told there was an easy fix or no fix at all.. that we could try certain drugs first or that we would have to go straight to the BIG treatments. On top of that, I had to have my physical exam and though I had read quite a bit about it and had read it was nothing to worry about whatsoever, I was nervous because I actually found my last smear pretty horrible. 

We arrived at the clinic just before 9am and waited for my husband to be called in to do his bit (SA). This was his third one and so that wasn’t really a big deal but he was a bit freaked out because the other tests he has done he has done at home – this was going to be done at the clinic and, I mean, even as a woman I can understand that must be weird as hell!! He has since told me all about the room and what was said to him before/after and though we laughed our heads off, I have to admit I am surprised that more men don’t have a mental block. Hubby said that there was a TV in there (for some visual stimulation lol) but he said he didn’t dare turn the TV on because he was petrified the sound would come blaring out and everyone in the waiting room would hear it and know it was him and think he was a perv! LOL. Oh this still makes me laugh now.

We were then meant to wait until 10am for my appointment but annoyingly we were still sitting in the waiting room at 10.30 and I was getting anxious. The waiting room was empty apart from us so I started to panic that they had scheduled us wrong and we wouldn’t end up being seen and then I wouldn’t get any answers agghhh (luckily that didn’t happen). Finally the consultant came to get us and took us into a private room and then asked me to follow him into another room for the exam. Hubby was apparently meant to/allowed to come but clearly freaked out and decided to stay where he was LOL. So off I went.

I have to say, the physical exam was nothing. The worst part about it was the initial inserting of the camera device bit being a bit uncomfortable (not as bad as a smear though) and the rest was fine! I got to watch the screen and the consultant started to talk me through what he was looking at. He told me that I had a “beautiful uterus” which made me LOL and me and the nurse joked about how that is a compliment you don’t get to hear every day (though I suspect she probably does if truth be told). He then told me that there were no cysts or fibroids, no POLYPS, no endo etc. That was great to hear. He then said he was going to count my follicles on one side and he counted 4. I had no idea whether that was good or bad – he said he wanted more. Luckily he then started to find more and ended up finding 9 on one side and 8 on the other. Apparently that is fine. 

He said something about my tubes but to be honest I don’t really know what he was looking for because I have read before that they can’t get a good look at your tubes from an internal ultrasound – who knows. Regardless, all looked good and then we were done and I was able to get dressed and go and join him and my husband in the other room.

I was relieved that bit was over and now excited for the longgggg awaited answers!!

The consultant started by saying to me and my husband that my scan was good and that there were no problems at all. YAY. He then said he had my blood results and that my AMH was fine (I can’t remember the exact number now but it was in the “normal” range apparently. He then said my vitamin D levels were high (which apparently was a good thing) and he said “I don’t know how you have managed that because I am darker skinned than you so mine should be higher than yours”.) He said “what do you do?” and I said I didn’t know, but that I did take supplements – he told me to continue taking them. 

All good so far then.

He then said to my husband “right, you’re up” and he clicked onto his name on his computer and brought up his SA results. As said before, he has had a few so we weren’t worried about his results. He started to talk us through the results and all was good. He then told us the percentage of “normal” swimmers my hub has and we were so happy because the normal is 4% and the last few tests my husband had 2%. Yesterday he had 6% and we were made up because he quit smoking 3 weeks ago and has been taking the conception vitamins and so this felt like real evidence of how hard he had tried AND how much smoking effected things. I was also secretly really pleased because I knew he would really feel good about getting his results up from 2% and below average to 6% and above average – partly for fertility/health reasons and partly for male pride/ego!!!

And so we moved on.. back to me.

The consultant said to me “thyroid” and I thought to myself “I bet there’s a problem”… I was right. Weirdly I was quite happy as he indicated something wasn’t right which I know sounds really odd but I had been hoping for such a long time that the doctors would find something fairly simple wrong with me that could easily be fixed. 

I would explain the ins and outs of my thyroid problem but to be honest I can’t because it is sooo confusing. The short version of the story is that my brain is telling my thyroid to work harder than it should be/needs to and that a particular level for pregnant women/women trying to conceive is no higher than 2 and that mine was nearly 6. Whoa! He then said that he was concerned that the reason for this was an auto-immune disease and so he said he wanted me to have an Anti-TPO blood test. This will tell us whether my thyroid problem is caused from an auto-immune disease such as Graves Disease. Basically my immune system could be making antibodies that attack my thyroid. 

My husband asked if this could be the cause of us not being able to conceive but he didn’t really answer that straight (he tended to talk fast and he did talk to us like we were doctors to be honest – sometimes I had to ask him to clarify things he was saying). The general gist of his response was “no” because personally I still ovulate each month, BUT he said that my thyroid the way it is would not be able to support a baby if I were pregnant and so it needs to be sorted. I asked whether I would need medication for the thyroid issue and he said yes but that the first step was to have the blood test and find out what the cause was.

I have since Goggled the life out of this stuff and actually being pregnant before this is controlled would be pretty dangerous! It says that having Graves disease (or another autoimmune thyroid disease) which was not under control could cause miscarriage, pre-term labour, stillbirth, preeclampsia, maternal heart failure, poor foetal growth. Agghhhhhhhhhhhhhhhhh!! Totally freaking out about this atm. So obviously this needs to be sorted ASAP.

He then said that it may be worth me having a HyCoSy (test to check my fallopian tubes are clear and not blocked). I was dreading him saying that to be honest because I have heard and read bad things about how painful it is – waaaahhh (yes I know, get over it if you want a baby..). He said he would be very surprised if I had any blockages given my background, lack of pregnancy, abortion or miscarriage and given how healthy my uterus was BUT it was worth checking and also, you can’t have IUI if your tubes are blocked. I told him that we had already paid for this test as part of our package and so I felt it was worth doing (as much as I hate to admit it).

Saying that, I have read that if your tubes are not blocked or even if they have a very tiny amount of tissue in them, this test kinda acts as a bit of a jet-wash and can really help. There are a lot of articles and forums online where women say they struggled to conceive for many years and then had this tube test and fell pregnant that same cycle or a cycle or two afterwards – imagiiinnneeee that!!

The doctor then went on to say that in summary my hub’s swimmers are great, my uterus is great and that we have age and BMI on our side. He said that I have regular cycles and ovulate naturally which were all really good. He said we basically had 3 options:

1)   Continue to try – but he understood that after 3 years, we may want to not wait much longer;

2)   Attempt IUI; or

3)   Attempt IVF.

He then spoke us through the differences between IUI and IVF. He showed us diagrams and photos and spoke about the pain and costs associated with both. To be honest I already knew a fair bit of what he was telling us (again – thanks Google!) but my hub looked completely lost lol. 

He told us that he didn’t think IUI was really that worthwhile for us because of our particular situation (i.e. that there were no obvious problems, thyroid aside). I asked him what the benefit would be and he said (whilst showing us a diagram) that it would mean we had all the very best swimmers (dead/abnormal ones cleaned away) and that they would be inserted via a catheter right up to my tubes meaning they had a much better chance of getting where they needed to go basically. He said the chances of success were between 15-20% for us. 

We then spoke about IVF and he told us about the drugs and injections and how the eggs would be taken out, fertilised (hopefully) and put back in. I asked him how painful each step of that was and he answered. He told us that the chances of success were higher and for us, about 54%. So quite a big difference in terms of success rates. Annoyingly the price difference is quite big too. A round of “natural” IUI (no hormones or drugs) would cost us £1,100. A round of full on IVF would be £5,000 but there are “extras” which total nearly another £1,000 and whilst you don’t need the extras, I think most people probably take them because if you are going to put yourself through this much and spend that much – I imagine you feel you would be mad not to pay the extra and get all the extra help you can. I know others may not feel like that. I don’t know how I feel yet.

We then left the room and went to speak to a nurse about the costs involved in all our different options and then I had the blood test for the thyroid thing and booked in the HyCoSy (tube test) for next week. I then had to do a urine test because they have to check you for chlamydia before they test your tubes. 

And then we finally left with what felt like a gazillion leaflets and A LOT to think about.

I felt happy. Hubby didn’t seem to feel half as happy as me – I wasn’t sure why. Unfortunately hubby had to go to work after and so we both had the rest of the day separate and unable to discuss anything but it gave us time to digest it all a little and I got to speak to T. 

Finally last night we went for a drive and had a chat about it all and we came up with an action plan (I have to have one otherwise I let it totally preoccupy me for days/weeks). Our action plan is:

1)   Get results back re thyroid/auto-immune system disease and sort out medication for that. I need to find out how long the meds will take to work properly – enough that if I were to fall pregnant, neither myself or the baby would be at risk. This is clearly the most important step for now.

2)   Get tube test done next week and find out if tubes are blocked or open as that will help decide future steps.

3)   Once tubes have been jet-washed (and we know they are open (fingers crossed) AND my thyroid has been sorted out – potentially we could try naturally for another few cycles).

4)   Then (if tubes open) try a round of IUI. Despite the doctor telling us the success rates, we feel it would be worth a shot because we don’t have a spare £6k and it would take us a long while to save that amount PLUS once everything else has been hopefully fixed, it might just give us a little helping hand without having to go through the gruelling hormones and injections and egg harvesting etc. We feel it is worth a go even if the odds aren’t fantastic.

5)   Lastly: save for IVF.

I feel quite good today. I mean, there is clearly a lot of stuff to take in and fully understand here and I am slightly concerned about this autoimmune thing. I am nervous about what that could mean if I were to get pregnant but I am relieved that I know the other things are in our favour (no cysts, good sperm, good egg supply etc). It could certainly be worse.

That’s where we are now… I am just being a scaredy-cat about the tube test next week and I will probably Google more things and then wish I hadn’t – clearly I have a Google addiction.

If anyone has been through any of this and would like to leave me a comment, I would really love to hear your thoughts/stories! Anyone with Graves or thyroid issues that has had trouble conceiving or anyone that is/was on thyroid meds and had a pregnancy? Anything really – I don’t have anyone in my “real” life to talk to so I would love a conversation. 

Twink x