In Vitro Undressed: Sonohysterogram and IVF Orientation

The sonohysterogram test sounded horrifying. They perform an ultrasound, wash the uterus with iodine to prevent infection, fill the uterus with saline using a catheter so they can observe better if there are any problems with the uterus, and lastly they take a bit of the lining of the uterus and this is biopsied to check for problems (endometrial biopsy- not done in all sonohysterograms, but was to be done in mine). Research has shown that this test can allow blastocysts to implant better and thus it is often done before the first round of IVF to improve the chances of success.

Given the discomfort of the HSG test with the contrast dye in the fallopian tubes (major cramping and then bleeding, like having a short bonus period) and the fact that they said that this test would take 10 minutes (the HSG took about 2-3), I was terrified. It sounded so painful and the write up they gave me wasn't very reassuring (I know they have to prepare you for the worst).

I visited the Victoria Fertility Centre office five days after our last visit. My sister drove me there and then took her baby for a walk so the whole office wouldn't have to hear her howls of dismay at being trapped in a clinical environment for an hour and a half. My husband has been working in a different province during the week for the last couple of months, so I didn't have him there and I rather wished that I could have, because I felt nervous and alone.

I paid the deposit for the IVF process ($1,500) and then was taken to an examination room. I had to wait a while for Dr. Hudson and I amused myself by taking selfies on the exam table. The nurse set up. Dr. Hudson turned the screen, so that I could take some photos for the blog. He's very kind. He showed me the uterus first (they do an ultrasound first), then both of my ovaries, with one of them having a follicle that was just about to rupture (so ovulation was imminent). He said that my bladder was so full (shouldn't have had that extra cup of tea) that it had pushed the uterus up and that he would have to "pull it down" (I said "that sounds horrifying." The nurse laughed, but he just soldiered on). I had cramping with the "pulling down" of the uterus, then the iodine, saline, and excision all happened in about two minutes, as I deep breathed and stared up at the ceiling tiles. Then suddenly we were done.

I think the whole procedure took about five minutes start to finish and for pain level, it was uncomfortable and crampy, but not near as bad as the HSG test, for me at least. The bleeding after was minimal, much less than the HSG test, for me anyways.

I went to sit in the waiting room and then my lovely orientation nurse came to give me my IVF orientation session. She gave me a cup of tea (how civilized, good luck finding that at any other doctor's office). She had asked what day I was in my cycle (day 14) and she produced a calendar with when I would start the first hormone (Estrace), when I would start injectable hormones (she'll teach me how to inject myself with these drugs once I return for my blood tests and ultrasound at the start of my next period on day 2 or 3 of my cycle), and the day by day process leading up the egg retrieval, fertilization of the eggs, and then implantation.

She answered all of my questions about how much the hormones would make me swell and other side effects, what the survival rate is of the frozen embryos (97%), how much a frozen embryo transfer costs if the first IVF cycle doesn't succeed and there are any frozen embryos to work with ($1,300), the level of pain associated with egg retrieval and what they do to make you more comfortable, and what does the implantation procedure feel like.

I found that about half an hour with her alleviated a lot of my anxiety about this alien procedure, especially because not only did she have an excellent bedside matter, but she was also very knowledgeable, and her sense of humour didn't hurt either.