As I mentioned in the previous blog, a Hysterosalpingogram (HSG) is an X-ray procedure that is used to view the inside of the uterus and fallopian tubes. A catheter is inserted through the cervix and into the uterus, and then contrast dye is injected. X-rays are taken throughout so that the radiologist can see where the dye goes. It’s often used to check for blockages of the fallopian tubes. It can also help identify any polyps, fibroids, scar tissue, or abnormalities in the shape of the uterus.

The Hysterosalpingogram (HSG) X-ray

On November 23^rd 2021, I turned up for my HSG. I was taken through from reception within a few minutes and gowned up. I entered the X-ray room where the staff checked my details again and went through any risks of the procedure. They asked if I had any concerns and I told them I’m a pro at contrast X-rays etc. at this point, so I have no worries. I was actually just thrilled that the test day had arrived. The reality was that I had waited for these answers for years. I was excited because I could see the screens, and then the staff told me that the X-ray machine would block my view. But they did say I could look at the final image after. Yay!

I lay on the table, legs spread. The nurse lubes me up and inserts a speculum into my vagina. Next, she goes in with the catheter. After about a minute, she stops and asks another nurse for an olive. I tell them I am partial to an olive, but never before have I had one in my vagina! This is actually an olive-tipped coude catheter. A coude catheter is designed to manoeuvre around obstructions or blockages and features a slight bend at the end. Olive refers to the rounded or ball-shaped tip.

It won’t go in.

Apparently, the opening to my cervix is too narrow – probably due to adhesions/scar tissue from my previous bowel surgeries. Bit anticlimactic. They are so apologetic. Maybe particularly because I mentioned I’ve waited years for these answers. I tell them it’s fine. It’s just another part of the journey. They will write a report for the Gynaecologist who will then be in touch with a different test option. Bugger! On the bright side, I figure I get to experience more tests which might be useful to share with people going through a fertility testing journey. Silver lining?

The same day, I called Gynaecology myself and left a message to say that the test had been a failure so I wanted to know what was next, and I’d also lost my blood form. I didn’t want things to be held up any further. The new blood form arrived a few days later, so I knew they’d got my message. A few weeks after that, I got a text to say that I’d got another Gynae appointment on January 27^th 2022.

I finally went for my blood test on January 12^th 2022. The results never turned up on the GP system. I chased them on the 21^st to see if they’d been logged somewhere they shouldn’t have been again. Nope. The receptionist had no idea why they weren’t there and asked me to call back on Monday, like they might have miraculously turned up by then? Anyway, I didn’t bother. I thought I’d wait for my Gynae appointment on the 27^th.

Medications and pregnancy

Somewhere in the middle of this journey so far, I had an appointment at the pain management clinic. I said I wanted to stop the Gabapentin as I didn’t feel like it was doing anything in terms of pain, and it wasn’t a good idea to take it if I were to become pregnant at any point. I said that future medications needed to take into consideration a possible future conception. We made a plan to come off the Gabapentin, and to try Duloxetine. I started decreasing Gabapentin, but when I tried to get below 800mg 3 times a day, it became clear that they had actually been helping. I called the GP to get the Duloxetine prescribed. I figured they might help and then I could try to taper down with the Gabapentin again. I collected the Duloxetine, read the patient information info, and decided, no. I wasn’t taking it.

Key reasons (copied from patient info leaflet):

When taken during pregnancy, similar drugs (SSRIs) may increase the risk of a serious condition in babies, called persistent pulmonary hypertension of the newborn (PPHN), making the baby breathe faster and appear bluish. These symptoms usually begin during the first 24 hours after the baby is born.

If you take Duloxetine near the end of your pregnancy, your baby might have some symptoms when it is born. These usually begin at birth or within a few days of your baby being born. These symptoms may include floppy muscles, trembling, jitteriness, not feeding properly, trouble with breathing and fits.

If you take Duloxetine near the end of your pregnancy there is an increased risk of excessive vaginal bleeding shortly after birth, especially if you have a history of bleeding disorders.

If Duloxetine is taken during the second half of pregnancy, there may be an increased risk that the infant will be born early.

So, that’s that. Moving on.