Episode 2 : Poked and Prodded
Trigger warning — this episode describes medical procedures in some detail and may not be for the faint-hearted.
As I wrote last time, me and my partner paid for some private fertility tests as a first step in discovering why we had been unable to conceive, following over a year of negative pregnancy tests. For my partner, this was a reasonably straight-forward affair, depositing his sample at the clinic and waiting for the results. Although in the interests of full disclosure, depositing rooms, as we’ll call them, are not exactly the ideal place to get the deed done. According to my other half, who has by now experienced a variety of these rooms, they are bare, uncomfortable and usually empty but for a chair in the corner. He even had the pleasure of hearing the staff in the lab next door in one room, who he then had to pass his sample to through a small hatch in the wall. Needless to say, we’d recommend bringing your own materials to make things as easy as possible as you wont get any creature comforts at a fertility clinic.
My experience was a little different, but still relatively straight-forward at this stage. The AMH test is a simple blood test to ascertain your Anti-Mullerian Hormone level; this hormone is an indicator of your ovarian reserve, or the number of eggs you have. Next came the ultrasound scan. We read about these tests on various websites before booking, and all the literature describes this as a pelvic scan. Me being very inexperienced in these things, and never having had any kind of ultrasound scan before, I assumed this would be a jelly on the belly type affair. For reference — all my fertility related scans so far have been internal. My stomach dropped when the nurse calmly explained to me that this would be an internal scan, so she just needed me to take off all the clothes on my lower half, jump up onto the edge of the plinth, lay back and put my legs up in the stirrups…
As it turns out, the actual scan was no big deal at all, not painful in any way and over pretty quickly, but boy was it a shock when I had thought I’d just be unbuttoning my jeans slightly. The nurse was able to tell me there and then that my womb and ovaries looked normal and that I had a good amount of antral follicles, or egg-containing follicles, which looked capable of producing mature eggs. Overall, our fertility MOT revealed very little, other than we both looked quite normal and we should be able to conceive based on those tests. We were advised to wait three months and re-contact the clinic if we were still only getting that single pink line.
And so, three months later I was on the phone once again and I was advised that a Hysterosalpingo Contrast Sonography or HyCoSy procedure would be the next step in the testing process. This test involves injecting a solution into the fallopian tubes via a catheter and then performing an internal ultrasound scan to check the tubes for any narrowing or blockages, at a cost of a further £450. There is some evidence too, we were told, that the sterile fluid can have a sort of wash-out effect on the womb and that chances of conceiving naturally may be slightly higher for a couple of months after the test. Great, we thought, let’s go for it. I turned up at the clinic, this time at least aware I’d have to get naked from the waist down again, and feeling a little more mentally prepared for it. Sadly for me, this procedure didn’t go quite to plan and it was all a lot more lengthy and uncomfortable than is usual. But hey, I’m here to tell you about my experience warts and all, so here it goes.
The procedure requires a speculum to be inserted, as during a smear test, so that part was familiar. Once the doctor has a good view, they use a fine catheter to pass into the womb to deliver the fluid. This was where things got a bit more tricky for me. As the doctor told me at that point, my womb is quite forwardly tilted, so my cervix is not straight. He fiddled around for quite some time trying to pass the catheter through, causing some intense cramping sensations that made me squirm. He attempted to inject the fluid with the catheter partially inserted, but this didn’t work, so he ended up using a tool called a tenaculum to straighten my cervix. This eventually enabled him to pass the catheter and the fluid as needed and then the internal ultrasound was completed to assess my fallopian tubes. Luckily no issues were identified, although I couldn’t help feeling we were now hundreds of pounds and my dignity down with nothing to show for it. I thanked the doctor and nurse and waddled out in the inch thick sanitary pad they had provided for any post-procedure bleeding.
We had a follow up consultation via video call to confirm that our results were all normal and that we should continue to try to conceive naturally for a further three months and then consider asking our GP for a referral for IVF. The doctor also kindly gave us some information about a further test, still in its infancy and not provided by their clinic, that we may be interested in. This test, called SpermComet, tests sperm for DNA damage, which cannot be detected in a standard semen analysis, and can contribute to male infertility. This test cost a further £500. We deliberated for some time and finally decided it was worth doing, so once again my partner had to schlep to a cold, sterile room and produce his sample. The results arrived via email a couple of weeks later, but that’s a story for next time.
