all you ever wanted to know about my uterus

Okay, so maybe you didn't exactly ask to know about my uterus, but I'm going to tell you anyway.  I wish my uterus was your normal, everyday, boring uterus.  But unfortunately, it's not.  If it were, I probably wouldn't be here writing about my struggles with infertility.

I'll start with my first HSG (hysterosalpingogram) test from 2007.  My RE at the time suggested that we begin looking into the cause of my infertility with a look at my uterus and fallopian tubes.  The purpose of the HSG test is to show if the fallopian tubes are blocked or if there are any injuries or abnormal structures in the uterus, thus preventing the egg and the sperm from meeting or the embryo from implanting on the uterine wall.  The test is performed by inserting a catheter through the cervix and into the uterus, then blowing up the balloon at the end of the tube once it is in the uterus to expand it for examination.  Dye is then administered through the catheter and x-rays are taken of the uterus and tubes as the dye passes through.  If the fallopian tubes are not blocked, the dye will move freely through them and spill out the other end where the ovaries are located (I assume the dye is later absorbed by the body).  If the tubes are blocked, the dye will not flow through the fallopian tubes to the ovaries.

I was so naive about the physical pain of infertility back then.  Thinking nothing of it, I scheduled my appointment, for my HSG test, followed all of the pre-procedure information the day of my appointment ('take 6 ibuprofen one hour before the appointment; there will probably be discomfort and cramping'), and put my uterus in the doctor's hands.  And it began.  The Dr. could not get the catheter past my cervix.  I was in so much pain that I lost track of how long she tried to get that cursed thing through (15 minutes maybe?  Maybe longer?).  'Do I have an incompetent doctor or is it me?'  I was leaning more toward it being the fault of the doctor.

The warnings about cramping were a joke.  This was not normal cramping like you get with your period.  It wasn't even normal cramping like you get with your period if you have endometriosis (which I had not yet been diagnosed with).  This was '6 ibuprofen is all you told me to take??  What is wrong with you?!  I should be anesthetized for this type of procedure!  I'm going to rip your head off when I get off this table!' type of pain.  I was crying and grasping the side of the table and trying to regulate my breathing.  'Wiggle your toes; it'll take your mind off the pain' is all the doctor would tell me.

Finally, FINALLY, she was able to get the catheter through, flush the dye, and see it spill through my tubes and past my ovaries.  Everything was clear!  Hooray!  That's one more test checked off the list and one more test that was normal (except for my stubborn cervix - or was it the doctor?).

Fast forward a few years to my laparoscopy in 2010.  My new ob/gyn performed a tubal dye study during my surgery in the hopes of avoiding another HSG test.  The tubal dye study showed normal results (except for the small, accidental puncture in my uterus that occurred during surgery) and all was good.  Until this year when she recommended I revisit the HSG test; after all, it's been 5 years since my last one and things could have changed since then.

I scheduled the appointment (again) and made sure to warn my ob/gyn of the problems the last doctor had with the catheter.  I took my ibuprofen and tried to mentally prepare myself for the ensuing pain.  Once again, the catheter would not move past my cervix.  'It's definitely me and not the doctors' I thought, frustrated. 'Why do I have to have such a stubborn cervix!'

When the pain hit, I let my doctor know, but nothing could stop the tears...or my fingers from grasping the sides of the cold, hard table for support.  She told me to wiggle my toes.  'What is with these doctors and wiggling my toes?'  She told me to cough and that it would help open up my cervix for the catheter.  'I'll try anything at this point!  Cough, cough, cough, cough, cough.'  The catheter made it through and it didn't take nearly as long as the last time!  Still quite painful though.  She pushed the dye through and the x-ray tech took pictures of my lady parts as the dye spilled through to my ovaries again.  'I knew it!  I knew they would be clear again!'  I thanked God that something worked on me.

I asked my ob/gyn if the tightness of my cervix could be the reason why I'm not able to get pregnant.  She said it's not likely and that if my cervix were water tight (meaning that even blood would not be able to leave my uterus during my period), then that would be a problem.  But since the blood does leave my body every month, then my uterus is not water tight and that is not what the issue is.

A few months later, I had an appointment with my new RE for a hysterosonogram (HSN or saline sonogram).  I asked in advance what the procedure would be like and if I needed to take ibuprofen like I did for the HSG test.  The nurse said no, that there might be mild cramping but nothing like the HSG.  She said it's a much easier test than the HSG.

I went to my appointment with a full bladder and no ibuprofen.  I couldn't remember for sure if I needed to have a full bladder so I went with one just in case.  I asked the nurse when I arrived if I needed a full bladder and she said no so I used the restroom before my appointment.  I went back to my assigned room and my RE came in to do the HSN.  And guess what!  He couldn't get the catheter past my cervix!  I know, shocking, right?

The intense pain started again.  After a few minutes he stopped the test and told me to reschedule my appointment and come back WITH A FULL BLADDER.  'Are you kidding me??  I just had a full bladder 5 minutes ago!' I said to myself.  I was much more polite when I said it out loud.  He said the nurse had informed him that I did have a full bladder a few minutes ago and he apologized.  I also asked if it was ok to take ibuprofen before the next HSN attempt and he said yes.  Needless to say (but I will say it anyway), I was pretty ticked at the nursing staff.

Two or three days later, I returned to repeat the test with a full bladder and 6 ibuprofen in my system.  My RE entered my room with a nurse and had the nurse go over my belly with a 3-D u/s instrument.  My full bladder combined with the 3-D ultrasound was just what the doctor ordered.  ; )  After a minute or two of cramping, my RE found a path through my cervix and it all seemed so easy.  'Why didn't the other doctors do this for my HSG tests??'  He looked at my uterus and noted that it is on my left side and is 'horned-shaped' rather than a typical triangle shape.  Of course it couldn't be normal.  But at least he was able to map a path through my cervix!  Hopefully any similar tests in the future will be simple now (knock on wood).