Fertility Update — Blood tests, Ultrasound, HSG
By Alina Avery
I left off our fertility story after we made our first appointment for a visit to a Reproductive Endocrinologist to figure out why we weren’t having any luck trying to conceive and what our possible options are moving forward.
We chose Boston IVF/IVF New England, which used to be two separate organizations, but have merged into one. It’s honestly a bit confusing since there are so many office across Massachusetts, New Hampshire, Rhode Island, etc. and they all have different names. We chose our doctor, Dr. Wright, based on the recommendation of a friend of Matt’s sister. Her office is a bit farther away, but honestly there were an overwhelming number of options so it was nice to have a little guidance. And to me, feeling confident and comfortable with our doctor is worth the longer drive. When we were making the initial appointment I also made sure that we could change to a different office or a different doctor if we felt things weren’t working out, since our first appointment would also be our first conversation with our doctor.
Luckily, Dr. Wright was great and answered all of our questions. We didn’t feel rushed or belittled or judged and she took our history, listened to our concerns, gave us more information on our options, both short and long term. She was also knowledgable about our insurance and what would or would not be covered. I appreciated that, since a lot of times it seems like doctors don’t concern themselves with insurance and let the billing office handle it, which can lead to a disconnect between what treatment you can afford and what you are given. Especially since fertility treatments can be so expensive, it’s nice to know that everyone is aware and conscious of cost. We spent about 45 minutes discussing our case and then met with an admin to go over the suite of tests that Dr. Wright had ordered and how and when to schedule them.
For me, I was told to call the office on the first day of my next period to schedule blood tests and an ultrasound for day 3 of my period. Then sometime between day 5 and day 12 of my cycle, I’d go back in for an HSG or a “dye test”, where they’d inject a contrast dye into my uterine cavity and then use an x-ray machine to make sure my tubes were open. For Matt, he’d do a second semen analysis and also a blood test. My period wasn’t due for another 3 weeks, so it was back to waiting. I don’t think I’ve ever been so excited to get my period and probably never will be again.
I’ve always been (weirdly) totally fine with needles, so the blood draw was the easiest part. They did an STI panel, tested my hormone levels, and sent some off for genetic testing. The genetic testing is to determine if Matt and I are both recessive carriers for certain genetic mutations or diseases, so if we end up doing IVF, they’ll be able to screen the embryos to make sure they aren’t affected. In my opinion, it was a little early to be concerned about that, especially since we don’t have a family history of any of the issues they’re screening for, but if they’re taking blood anyway might as well tack that on.
The ultrasound was slightly less comfortable. It’s an internal test, so they have a wand they use to measure your organs and count antral follicles, which is a way of measuring ovarian reserve or the number of eggs you’ve got left. They also make sure there aren’t any ovarian or uterine cysts and that the lining of the uterus looks appropriate for where you are in your cycle.
Finally, the HSG a week later was definitely the least comfortable, and definitely the weirdest. I told Matt after that it was kind of bizarre to see an x-ray of my pelvic bone. I mean, I know I have a skeleton, it was just strange to see it projected on a monitor! The whole procedure only took about 60 seconds, but a very uncomfortable 60 seconds.
For Matt, it was very straight forward, all he had to do was go into a special room to “produce” into a cup. . We scheduled our visits so we could go in at the same time. I thought that the HSG would take longer and Matt’s specimen production would be relatively quick and he’d end up waiting for me, but my test was actually super speedy and we had to wait a while for a room to open up for Matt.
The initial results are mostly posted on our patient portal, and from my compulsive and incessant Googling, all the numbers seem normal, and both my tubes are free and clear. The genetic testing takes longer, and we don’t have Matt’s results yet, but from his first test back in 2015, we know at least roughly what we can expect. Our next step is to schedule a follow up visit with the doctor, but the next availability isn’t for a few weeks, so we’ll have to be patient. The waiting is definitely the worst part, especially since we’ve made the decision to go ahead and seek intervention. I wish I’d known that sooner so I could have prepared myself for the timeline. It seems obvious now, but I thought that it would be relatively quick between our first appointment and starting treatment, even if the treatment itself took a while. It’s a special kind of torture. When I brought this up to Matt he was surprised that I was surprised at how spread out everything is. He (rightly) expected a much more drawn out timeline.
So I guess the next post will be any news from the follow up and what our course of action will be. I also might do a quick update on the cost we’ve incurred so far, since I know that’s a factor for a lot of people. Luckily we have excellent insurance, but I’m still bracing myself for a bill.
