Do doctors try Clomid before scheduling an HSG?

[Dottiee]

Hey ladies,

I'm just curious if doctors try Clomid before scheduling an HSG, or if it is the other way around.

I have my specialist appointment in December, and I have absolutely no idea what to expect. My family doctor told me he will likely do an HSG, however I'm reading so many posts on this forum saying they tried Clomid first.

An HSG terrifies me, so I'd be really happy to hear that I can try something else before having to go through that.

Edit: Been TTC for 24 months, cycles lasting 4-7 months

 

[Spockette]

Hi Dottiee,

I saw that no one has replied to your post so I wanted to reply.

I've never had Clomid but I have had an HSG.

My story is that I conceived my daughter within the month but the second one was taking a bit longer. 17 months to be precise! Anyway, I had my HSG and fell pregnant with her a month later

I'm not sure what it's like in the states but here in the UK I think most women will have to go through a HSG before they are given Clomid. The HSG is part of a group of diagnostic tests to determine if there might be something preventing you from getting pregnant. This also includes your other half having a sperm analysis! No point in prescribing Clomid unless everything checks out ok. Having said that, there have been ladies who have been given Clomid without the HSG but I personally wouldn't do it. It's quite a powerful drug and you might not actually need it!

As for the HSG itself, I know it's daunting! Believe me, I've been there but I felt no pain whatsoever! The only uncomfortable feeling I felt was the catheter going in. Felt nothing else and it was over in 5 minutes. There are women who have been in pain (as you've probably read) but that could be for a number of reasons, blocked tube(s), the consultant might inject the dye too quickly etc. Remember, it's just an X-Ray. Not an operation

I would say do it because you might always wonder...

Good luck xxx

 

[Dottiee]

Thank you so much for your reply!

I'm in Canada so I haven't heard any stories of the order they do things here, but I'm sure it's similar to the UK. OH already has a daughter from a previous marriage and very healthy swimmers We got that done right away.

An HSG freaks me out so much. I have a pretty high pain tolerance (I'm covered in tattoos), so it's not the pain that scares me. It's more of just the idea of what's happening. I'll take a bunch of Ativan before I go to keep my head calm lol

 

[2have4kids]

Hi Dottiee, I'm in Calgary and th fc here won't do anything for you until you've done 1. U/S 2. Hsg test 3. SA and 4. Bloods that indicate your fsh, estrogen and progesterone on cd21. Then they'll recommend a course of action based on your diagnosis.
They won't test for reproductive immune issues so if all of your tests come back without an indication of an issue, ask for a referral to a Reproductive Immunologist. You can still do fc treatments but if you have immune issues and they don't give you prednisone/heprine or the intralipid iv necessary for women with these issues, you'll continue to get bfn's until you sort through what's causing your issues.

I had an hsg it REALLY wasn't that bad!! It's just the beginning of the process to being a Sturrup Queen lol (welcome). The next is multiple iui's, then possibly an IVF where they put a needle through your ovary to collect eggs (in Canada they don't knock us out, it's just a general numbing) and then a catheter to implant the blasts. Then, the most invasive...pushing that melon out once we've finally achieved our bfp. Really, don't be scared. March in there and get it over with so that you can start on your path to success!

 

[Dottiee]

Hi Dottiee, I'm in Calgary and th fc here won't do anything for you until you've done 1. U/S 2. Hsg test 3. SA and 4. Bloods that indicate your fsh, estrogen and progesterone on cd21. Then they'll recommend a course of action based on your diagnosis.
They won't test for reproductive immune issues so if all of your tests come back without an indication of an issue, ask for a referral to a Reproductive Immunologist. You can still do fc treatments but if you have immune issues and they don't give you prednisone/heprine or the intralipid iv necessary for women with these issues, you'll continue to get bfn's until you sort through what's causing your issues.

I had an hsg it REALLY wasn't that bad!! It's just the beginning of the process to being a Sturrup Queen lol (welcome). The next is multiple iui's, then possibly an IVF where they put a needle through your ovary to collect eggs (in Canada they don't knock us out, it's just a general numbing) and then a catheter to implant the blasts. Then, the most invasive...pushing that melon out once we've finally achieved our bfp. Really, don't be scared. March in there and get it over with so that you can start on your path to success!

Wow! Thanks so much for all the info.. I didn't even know about reproductive immune issues, and I've googled my a** off trying to find all the factors that can cause infertility.

I have an A- blood type, which my doctor said can cause problems with a fetus if it has an A+. Something about the immune system sensing it as a foreign body and attacking it. However, he said its nothing to worry about and I'd just need blood tests to ensure the antibodies aren't forming, and a shot around 21 weeks. Does that fall under the category of reproductive immune issues?

 

[2have4kids]

Not quite, I'm in your same boat with RH-blood type though. Don't worry, blood type is easy to resolve and would never hinder your chances of getting a bfp. It's resoved by mom recieving an rh immune globulin at 27-28 weeks and just before (or is it after??) giving birth. The injection is primarily meant to protect her second baby from being rejected if she forms antibodies with her first baby. It only happens that you form antibodies if your baby bleeds into your blood (happens mostly with delivery).
https://www.mayoclinic.com/health/rh-factor/MY01163/DSECTION=why-its-done

Reproductive Immune info can be found here: https://www.repro-med.net/repro-med-site2/index.php?option=com_content&view=article&id=34&Itemid=11
https://www.zitawest.com/assisted-fertility/assisted-fertility-consultations/two-or-more-unsuccessful-ivf-cycles/reproductive-immunology/

Immune issues aren't as likely common as blocked tubes, PCOS, and Diminished ovarian reserves (DOR is a diagnosis in particular why you should get into a fertility clinic asap). If you have DOR, you need to work fast to get in to do IUI/IVF before your time runs out. My gf is in her 20's and was given this diagnosis. She's dithering her time away playing with acupuncture and supplements. When you hve this diagnosis you need to move as fast as you can if you want to have a family using your own eggs.
My colleague was 31 and diagnosed with DOR. She was told by our fc not even to try chlomid, iui to go straight to ivf. It failed on her 3 times. She and her partner broke up and got divorced while waiting on an adoption list. I was diagnosed with it at 36, I've had 1 natural bfp, 2 failed iui's and 2 failed ivf's. I hope you have something that's easy to figure out but don't waste time if you can help it!!

 

[Dottiee]

Not quite, I'm in your same boat with RH-blood type though. Don't worry, blood type is easy to resolve and would never hinder your chances of getting a bfp. It's resoved by mom recieving an rh immune globulin at 27-28 weeks and just before (or is it after??) giving birth. The injection is primarily meant to protect her second baby from being rejected if she forms antibodies with her first baby. It only happens that you form antibodies if your baby bleeds into your blood (happens mostly with delivery).
https://www.mayoclinic.com/health/rh-factor/MY01163/DSECTION=why-its-done

Reproductive Immune info can be found here: https://www.repro-med.net/repro-med-site2/index.php?option=com_content&view=article&id=34&Itemid=11
https://www.zitawest.com/assisted-fertility/assisted-fertility-consultations/two-or-more-unsuccessful-ivf-cycles/reproductive-immunology/

Immune issues aren't as likely common as blocked tubes, PCOS, and Diminished ovarian reserves (DOR is a diagnosis in particular why you should get into a fertility clinic asap). If you have DOR, you need to work fast to get in to do IUI/IVF before your time runs out. My gf is in her 20's and was given this diagnosis. She's dithering her time away playing with acupuncture and supplements. When you hve this diagnosis you need to move as fast as you can if you want to have a family using your own eggs.
My colleague was 31 and diagnosed with DOR. She was told by our fc not even to try chlomid, iui to go straight to ivf. It failed on her 3 times. She and her partner broke up and got divorced while waiting on an adoption list. I was diagnosed with it at 36, I've had 1 natural bfp, 2 failed iui's and 2 failed ivf's. I hope you have something that's easy to figure out but don't waste time if you can help it!!

Oh my gosh! I had no idea about any of this! I'm only 22, so if it is something that serious at least it will be caught early. I definitely wouldn't be dwindling. I'm so tired of waiting that if they said I need to go in surgery to remove my left leg before I get pregnant, I'd race them to the OR. I'm so sorry to hear that you're having to experience this My fingers are crossed that this struggle is over for you soon

 

[Dazed]

I did clomid before the HSG. I just asked my doc since he had given me the referral for the HSG if we could try clomid first and he was fine with it. It doesn't hurt to ask.

 

[KJM2]

I had an hsg but never Clomid, just wanted to say the hsg was absolutely fine, good luck

 

[Heatherlt]

I'm getting my HSG test tomorrow, and as said before it really doesn't make sense to take clomid if it's really blocked tubes causing the issue.

I got an ultrasound of my uterus to check it shape, for fibriods or polyps, see how thick/thin the lining was, and they also checked my ovaries for any cysts or abnormalities. Next up is my HSG to check my tubes for any blockages. Then I need some blood work done and another ultrasound done on CD3 to check my ovaries again. My husband already did his SA. and THEN we can come up with a treatment plan based on what's wrong.

 

[mmdrago]

I had HSG before clomid, but my Dr. seemed willing to try Clomid first if I wanted to. My HSG was very painful, I had one open tube with the other showing miinimal dye (Dr. said possibly tubs had muscle spasm which is common) I've had numerous ultrasounds as well.

Just wanted to add that I just recently had a saline sonogram (similar to HSG except it's saline instead of dye and they look on ultrasound instead of xray) in which they found a polyp/fibroid that both regular ultrasound AND HSG missed. Something about the fluid expanding the uterine cavity and ultrasound picking up more visualization inside the uterus.

 

[Dottiee]

Thanks for all your responses ladies. I really hope you all manage to get your BFP's soon after going through this long stressful journey

I have my appointment in less than 2 weeks now!! I'm so nervous and excited, I've been waiting 7 months for this. I'll let you ladies know what his plan of action is.

 

[popchick75]

I've had 3 HSGs. 2 didn't hurt and 1 did. Just remember, the entire procedure takes about 2 minutes. Even if it does hurt, anyone can tolerate pain for that amount of time

The benefit of doing the HSG first is that you are usually only allowed 6 rounds of Clomid. If you use them up and *then* do the HSG and find out your tubes are blocked then you wasted all 6 chances.