Should I have done the HSG?

Netpetal · 03-16-2009, 08:27 PM

Our RE diagnosed us with 1 male and multiple female infertility factors. Based on our test results and the fact that I've never had a pelvic infection or an STD he decided that it was okay to skip the HSG. Since we are funding this 100% out of pocket I was happy to pass on the $1k procedure.

Technically we've had two failed IUI cycles. My NP said that the first really didn't count because my P4 levels were too low to support conception. My second IUI; however, was textbook perfect. I responded really well to the Clomid and produced three follices which all released. The inseminations were timed perfectly and this time with the help of Hcg shots, my P4 level was high.

When I called today to let them know I had started, my NP was very surprised. She said there isn't anything we could have done differently. So, now I'm wondering if my tubes are in fact blocked.

Did anyone else skip the HSG? How common is it to have blocked tubes? Am I fretting over nothing?

OneTrackMind! · 03-21-2009, 03:41 AM

Netpetal-
Here is a cheaper alternative to the HSG... first, I am thinking you mean hysterosalpingogram (test with dye), right? A Sonohystogram is a test done in the office with an u/s machine, a special catheter and water. It will tell if your tubes are open because after they look at the inside of the uterus with the u/s and injected water, they inject air bubbles which you can see on u/s as they go up and out your tubes if your tubes are open. You should ask your RE about this.

Good luck!
Polly

Netpetal · 04-07-2009, 11:30 AM

So I finally got to ask my RE about the SHG (water ultrasound). She said that the SHG cannot diagnose any tube issues; it can only be used analyze the uterus. She explained that the SHG is done before IVF to ensure that the uterus is ready for implantation.

I've decided to go ahead and have the HSG done before this next round of IUI. I asked about pricing. Since we are self-pay the hospital will cut our cost by 40%. Our max cost will be $840. Normal billed cost to an insurance company is $1400.

luckypenny · 04-10-2009, 04:54 PM

My first RE sent us for sonohysterography to check my uterus and fallopian tubes, and I have an appointment with a new RE booked for October and he has requested that I have all testing done, including a sonohysterography at the same clinic where I went for my first SHG, prior to our appointment. My new RE sent me information re. the SHG that says:
Sonohysterography is an ultrasound examination that provides considerable information about your uterus and fallopian tubes without the use of X-rays, X-ray dye, or an anesthetic.
Indications for this are numerous and may include: irregular vaginal bleeding, infertility, miscarriages, any suspected abnormalities of the uterus, or as a preliminary evaluation for in-vitro fertilization.
A thin catheter is placed through the cervix into the uterus. Normal saline (a salt water solution) is instilled through the catheter in order to allow us to see the inside of the uterus and check the fallopian tubes.
The doctor that did my first SHG concluded that my fallopian tubes are open (new RE wants SHG done if it was not done within the last 3 months. Mine was over a year ago, so I will have to do it again).
Hope this provides some information about SHG if anyone is looking for it.

whitley · 04-12-2009, 09:07 AM

Quote:

Originally Posted by Netpetal

So I finally got to ask my RE about the SHG (water ultrasound). She said that the SHG cannot diagnose any tube issues; it can only be used analyze the uterus. She explained that the SHG is done before IVF to ensure that the uterus is ready for implantation.

You are correct. SHGs are not used to dx blocked tubes. (I've had 2 and they are only used before IVF to take a look at the uterus.) HSGs are best for the dx of blocked tubes. (I've had 3 of these...so I can pretty much tell you anything you want to know about 'em). HSGs can also detect scarring.

OneTrackMind! · 04-12-2009, 09:29 AM

I guess every doc is different, but a sonohystergram is NOT just for checking the uterus before IVF. As I said before, I used to work for a RE and I assisted with these procedures many many times. I too had this procedure done. They use the water injection to see the inside of the uterus via u/s, they then inject air through the same syringe and catheter. If your tubes are patent, the air comes out thru them and again you can see it on ultrasound. I did not have IVF, nor was I planning to. I had this done as part of my workup for IUI.

Hope all is well. I know this thread is kind of old, so I'm sure you are well under way in your IF treatment. Good luck

beanermama · 05-12-2009, 08:38 PM

I would have done the tests. I think it is very important to rule out any issues before proceeding with treatment.

at my clinic they won't even treat a first time client who refuses the test.

In canada though it is completely free, so for me there was no reason to say no.

I did refuse it though when I was trying for my 2nd child since I was pretty sure I was fine.

good luck with everything though.

susan74 · 05-20-2009, 02:54 PM

We hesitated to do an HGS as well, but finally the costs of our IUIs were starting to exceed the cost of the HSG and it was starting to look like the HSG would be wise so we would know if we were wasting our money on IUIs.

Well, we planned to spend the $1,000 on the test... and ta-daaa! When our bill came, we had only been billed for the test itself and not all the other stuff (lab fees, xray fees, whatever... I can't remember exactly what was billed to our insurance). Our final total? $127.00!!!

If we had known this before, we would certainly have had the test done sooner!

03-16-2009, 08:27 PM	#1 (permalink)
Netpetal 0-99 post 2 of hearts Join Date: Mar 2009 Location: Colorado Posts: 5	Should I have done the HSG? Our RE diagnosed us with 1 male and multiple female infertility factors. Based on our test results and the fact that I've never had a pelvic infection or an STD he decided that it was okay to skip the HSG. Since we are funding this 100% out of pocket I was happy to pass on the $1k procedure. Technically we've had two failed IUI cycles. My NP said that the first really didn't count because my P4 levels were too low to support conception. My second IUI; however, was textbook perfect. I responded really well to the Clomid and produced three follices which all released. The inseminations were timed perfectly and this time with the help of Hcg shots, my P4 level was high. When I called today to let them know I had started, my NP was very surprised. She said there isn't anything we could have done differently. So, now I'm wondering if my tubes are in fact blocked. Did anyone else skip the HSG? How common is it to have blocked tubes? Am I fretting over nothing?

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03-21-2009, 03:41 AM	#2 (permalink)
OneTrackMind! Registered User Join Date: Mar 2009 Location: Canton, MI Posts: 48	Netpetal- Here is a cheaper alternative to the HSG... first, I am thinking you mean hysterosalpingogram (test with dye), right? A Sonohystogram is a test done in the office with an u/s machine, a special catheter and water. It will tell if your tubes are open because after they look at the inside of the uterus with the u/s and injected water, they inject air bubbles which you can see on u/s as they go up and out your tubes if your tubes are open. You should ask your RE about this. Good luck! Polly

04-07-2009, 11:30 AM	#3 (permalink)
Netpetal 0-99 post 2 of hearts Join Date: Mar 2009 Location: Colorado Posts: 5	So I finally got to ask my RE about the SHG (water ultrasound). She said that the SHG cannot diagnose any tube issues; it can only be used analyze the uterus. She explained that the SHG is done before IVF to ensure that the uterus is ready for implantation. I've decided to go ahead and have the HSG done before this next round of IUI. I asked about pricing. Since we are self-pay the hospital will cut our cost by 40%. Our max cost will be $840. Normal billed cost to an insurance company is $1400.

04-10-2009, 04:54 PM	#4 (permalink)
luckypenny 100-199 post 3 of hearts Join Date: Sep 2008 Location: Ontario, Canada (2 hrs north of Toronto) Posts: 113	My first RE sent us for sonohysterography to check my uterus and fallopian tubes, and I have an appointment with a new RE booked for October and he has requested that I have all testing done, including a sonohysterography at the same clinic where I went for my first SHG, prior to our appointment. My new RE sent me information re. the SHG that says: Sonohysterography is an ultrasound examination that provides considerable information about your uterus and fallopian tubes without the use of X-rays, X-ray dye, or an anesthetic. Indications for this are numerous and may include: irregular vaginal bleeding, infertility, miscarriages, any suspected abnormalities of the uterus, or as a preliminary evaluation for in-vitro fertilization. A thin catheter is placed through the cervix into the uterus. Normal saline (a salt water solution) is instilled through the catheter in order to allow us to see the inside of the uterus and check the fallopian tubes. The doctor that did my first SHG concluded that my fallopian tubes are open (new RE wants SHG done if it was not done within the last 3 months. Mine was over a year ago, so I will have to do it again). Hope this provides some information about SHG if anyone is looking for it.

04-12-2009, 09:29 AM	#6 (permalink)
OneTrackMind! Registered User Join Date: Mar 2009 Location: Canton, MI Posts: 48	I guess every doc is different, but a sonohystergram is NOT just for checking the uterus before IVF. As I said before, I used to work for a RE and I assisted with these procedures many many times. I too had this procedure done. They use the water injection to see the inside of the uterus via u/s, they then inject air through the same syringe and catheter. If your tubes are patent, the air comes out thru them and again you can see it on ultrasound. I did not have IVF, nor was I planning to. I had this done as part of my workup for IUI. Hope all is well. I know this thread is kind of old, so I'm sure you are well under way in your IF treatment. Good luck

05-12-2009, 08:38 PM	#7 (permalink)
beanermama 0-99 post 2 of hearts Join Date: May 2009 Posts: 84	I would have done the tests. I think it is very important to rule out any issues before proceeding with treatment. at my clinic they won't even treat a first time client who refuses the test. In canada though it is completely free, so for me there was no reason to say no. I did refuse it though when I was trying for my 2nd child since I was pretty sure I was fine. good luck with everything though.

05-20-2009, 02:54 PM	#8 (permalink)
susan74 0-99 post 2 of hearts Join Date: May 2009 Posts: 40	We hesitated to do an HGS as well, but finally the costs of our IUIs were starting to exceed the cost of the HSG and it was starting to look like the HSG would be wise so we would know if we were wasting our money on IUIs. Well, we planned to spend the $1,000 on the test... and ta-daaa! When our bill came, we had only been billed for the test itself and not all the other stuff (lab fees, xray fees, whatever... I can't remember exactly what was billed to our insurance). Our final total? $127.00!!! If we had known this before, we would certainly have had the test done sooner!