What Will Thursday Bring?

Thursday...HSG day...scarred or not scarred? Move forward or who the hell knows what?

It all comes down to day after tomorrow. My appointment time is blissfully late, which means I don't need a sub. We need to leave no later than 2:30, and since I don't teach 9th period, I could leave early at 2:00 and get home in plenty of time for the hour and 20 minute drive to Buffalo. I got 5 mg of generic valium, which hopefully is enough to help me and my uterus relax.

The HSG (hysterosalpingogram) is so not my friend. I have had oodles of them. For the uninitiated, it's an X-ray of your uterus and fallopian tubes. Sounds harmless enough, except during this X-ray there is a catheter passed through your cervix with a fun little balloon placed just so IN your cervix, so that the catheter can pass dye into your uterus and there's enough pressure from the balloon "stopper" to let it build up and show the complete outline of your uterine cavity, and then have the dye shoot through your fallopian tubes and out into your gut, assuming those suckers are open. A barrel of laughs. You get two tests in one shot -- a test to make sure your fallopian tubes are open and normally shaped, and a test to see that there's nothing funky (like polyps, fibroids, or scar tissue) hiding out in your uterine cavity. Polyps should show up as little bumps, fibroids as bigger bumps, and scar tissue as jagged asteroid-like surface in profile. Most infertility patients need an HSG or a saline sonohysterogram (similar test, but an ultrasound and it's saline pushed into your uterus) every year, as they are preoperative tests for tubal issues or polyp/fibroid removal.

Mine have always been normal, despite the fact that I have had polyps removed from my uterus not once but twice.

My first HSG was run by a radiologist. I enjoy radiologists, and know one personally. However, if you have a choice when scheduling your HSG, BE ADAMANT THAT YOU HAVE AN RE DO THE PROCEDURE. Radiologists do these tests fairly infrequently. REs do them all the time. Your HSG will be less painful and more sensitive with an RE, if I can be allowed to generalize.

My first HSG resulted in me being told that one of my tubes was closed and not passing dye, and that this must be why I couldn't get pregnant. I was in the middle of one of my last injectible IUIs, and it was NOT THE NEWS I WANTED. Because this would be one more reason I couldn't get pregnant, not THE reason. But, while discussing converting to an IVF cycle, my RE discovered that the balloon hadn't been placed correctly. There wasn't enough pressure for the dye to pass through. They redid the test within 3 days and it was fine.

Except.

Except it HURT, both times. Both times the dye went through my right tube it hurt, a lot. And my uterus was cranky and crampy, but that was to be expected. I just felt it was more than "mild discomfort."

Then, I had a saline sonohysterogram instead the next year. And that hurt, but not as bad as the HSG. Then I had the ectopic and lost my right tube, my painful, apparently defective, baby-sucking right tube.

I had another HSG, this time in the office, which had recently acquired the equipment necessary so they didn't have to rely on radiologists. This time it wasn't too bad at all, and having no right tube made that part a little more bearable.

But now, now I have to go to a new hospital, where I've only ever had hysteroscopies, and find their radiology department. My RE is running the show, which is good. I am nervous that it is going to hurt the way it has in the past, the way anything uterine has hurt lately. I am nervous that that scar tissue and the removal has made my uterus more sensitive. I am nervous that there's scar tissue in my uterus, that has regrown with a fervor I only wish an embryo could match, and Thursday will mark a turning point.

If there's no scar tissue, we continue. We get our new dates for our fancy new protocol and get that show on the road. We get ready to thaw our last remaining DS embryos, our last blasts. We get this train moving, as soon as possible.

And if there is scar tissue?

I honestly don't know. I don't know if we do another surgery to try to eradicate it again (but why, since the last one wouldn't have taken care of that, so the benefits are...?). I don't know if the risks of continuing with Freddy Krueger Uterus far outweigh the pain of stopping now, with embryos in the freezer. I don't know if it means we're done, or just that there's choices to be made and then we accept some risk and move forward. How much risk can I accept at this point? How much more can I take?

The answer: not much more.

I am worried. I am scared. But I also have some level of relief that I have been cracking that adoption door open with my foot while we wait. That we have pretty much decided that another fresh cycle is just not happening. That these frozen embryos, the donor sperm blasts and the donor egg 2PNs, are what we've got left to work with. There will be no more. I can't handle it anymore. We can't handle it anymore. We need to move to a path that has more promise, that will end in a baby eventually, instead of this hideous limbo where we might be successful (but in reality have been wildly unsuccessful over, and over, and over again). A path where my body isn't a punching bag. It is a time of transition. And for as much as I worry and fear and have a sense of loss that I may never go on my maternity clothes shopping spree, never feel a kick, never hear a heartbeat coming from inside my belly, never have a traditional baby shower, never have our own birth story; there is a freedom in knowing that once these frozen embryos are gone, we are done. It's not easy, for sure. But instead of feeling mired in sadness and loss, I have some hope that another path might lead us to our baby(ies). And I am opening myself to that hope in advance of the HSG and these last two cycles.

Do I still hope this will work out medically? Of course I do. But can I see another way? Yes, yes, yes.

I did find some adoption books and they are EXCELLENT. I am planning a book review post in the near future when I finish them (I am parallel reading two right now and 2/3 through both of them, and then I have another I haven't started yet). Reading these books dispels myths and quells my fears, at least some of them. I feel power in information.

I am ready for Thursday, and whatever it may bring. I may be really, really, really disappointed and sad on Thursday, but that sadness could lead to the best chance of parenthood we have had. Or, I could be pleasantly surprised and off on our next adventure with our blasts, trying out this new plan and hoping it leads to success. Either way, emotions run high. I hope for the peace to sift through them and see the best path to our future as parents.