IVF #1, CD 7, Friday 12/7/12
Today was a pretty big day. I got my long-awaited IVF Calendar and I got my sonohyst and trial transfer.
My first question when Dr.M told me I needed to get a “sonohyst” was, “What the heck is a sonohyst?” My second question was, “How much is that going to hurt?”
A sonohyst (short for sonohysterogram) is a transvaginal ultrasound accompanied by a catheter that pushes saline solution into your uterus. In an IVF clinic they use this procedure to check for anything that might hinder the success of an IVF cycle like a polyp. You can read more about the sonohyst procedure here.
A trial transfer is basically going thru the motions of an embryo transfer without the embryos. At first I thought that the trial transfer sounded kind of silly and was probably a waste of my time. But after my experience today, I think it was time and money well spent.
I will preface my story below with a note that after the trial transfer the doctor told me, “This will be a challenging embryo transfer.” Don’t you just love that word “challenging?” After the sonohyst, he told me that this was his most difficult one ever.
All of that translated to one thing for me today: Pain. And lots of it.
It all started with a simple transvaginal ultrasound. That ultrasound, although embarrassing because the probe is placed in your vagina and you feel that you’ve lost all dignity with your legs wide open and you just want to close your eyes and never make eye contact with the doctor again, is virtually painless. The worst part is a little bit of pressure when he counts your antral follicles (I had 7 on one ovary and 8 on the other ovary. A little low for my age, but higher than he expected with an AMH of 1.02)
The next thing was the trial transfer. At this clinic there are 7 or 8 doctors so the chances that the doctor who you see for all your pre-embryo-transfer appointments is the same one who actually does the transfer are pretty slim. I think the purpose of the trial transfer is to alert the doctor who does the embryo transfer of any potential issues. It is also to get a measurement of the inside of the uterus (mine was 6.5 cm which Dr.M said was normal).
It starts with a speculum and then Dr.M used some big q-tip things to put iodine on my cervix. Then he tried to insert the measuring device. It wasn’t happening. My pain level was still pretty low at this point, maybe a 4.
Then he decided to postpone the trial transfer momentarily and try the sonohyst first. So he tried to insert the sonohyst catheter. It wasn’t happening. My pain level was getting a little higher.
At this point he mentioned that on difficult cases like mine sometimes doctors resort to using a tenaculum. That sounded ominous so I asked what it was. He said it was a clamp that is put on the cervix. Um… OUCH. But then he informed me proudly that he had never had to use one before and that he felt pretty confident that he wouldn’t have to use it on me either.
Next he asked the nurse for the smallest dilator they had and for a different kind of catheter called a Cook catheter. The Cook catheter didn’t work either. The dilator on the other hand… My pain shot right up to a 10. Tears were flowing freely. I was squeezing my mommy’s hand. Dr.M asked me how my pain level was. I desperately, desperately wanted to tell him I was at a 10, but I also desperately want a baby and that meant moving forward, so I told him I was at a 9. Fortunately he got the measurement and some very valuable information for the real embryo transfer: my uterus is anteverted and my cervix takes a very sharp left turn.
So, trial transfer done, next up was the sonohyst. He tried the Cook catheter again, but it still wouldn’t work. Then he asked the nurse for a Shepherd catheter. After she left to go look for it (she’d never heard of it) he told me that if they didn’t have it or if it didn’t work then he would have to use the tenaculum. Fortunately they got the Shepherd catheter and… it worked! They got it in! Then they got the transvaginal ultrasound inserted again and used a syringe to swiftly inject the saline. He got the pictures he needed to pronounce me ready to move forward with IVF!
So, how much did the sonohyst hurt? Actually the sonohyst itself didn’t really hurt that much. During the injection of the saline there was a little cramping, but it wasn’t bad at all. The worst part was the insertion of the catheters and dilator. Fortunately for most other women, if your cervix doesn’t have a crazy turn in it, then the insertion would probably cause only a little cramping as well. But there’s only one way to find out…!
One potential complication of the sonohyst is infection. Apparently it doesn’t happen often, but if it does it will be pretty obvious: a foul smell, pus-like discharge, cramping, etc. An antibiotic is needed to clear it up.
All in all today was a good day. I’m glad to feel like we’re finally making some progress. Now if we can just find some swimmers during Mr.E’s TESE biopsy. Fingers crossed!