Infertility treatments can be pretty overwhelming. There are a lot of steps to go through to get to the end goal. When starting out the first thing your doctor will most likely want to do is diagnostic testing. One of the first steps our patients go through when beginning fertility treatments is a uterine cavity evaluation. At our office, during diagnostic testing we generally have our patients go through 1 of 3 uterine cavity evaluations. SIS, HSG, or hysteroscopy with or without tubal catheterization.
- Saline Infusion Sonohysterography (a mouth full) so for short we call it an SIS. This test is super simple and quick. Pretty much its like getting a pap smear (really fun, right?) except they stick a catheter in your cervix and push saline through to fill up your endometrial cavity to see if its smooth. The point of an SIS is to see if you have polyps or anything else funky going on. An SIS does not address the patency (opening/expansion) of your fallopian tubes though.
- How long does an SIS take? Depending on how skilled your doctor is, the test is quick. I would guesstimate it to be around 15 minutes!
- How much does an SIS hurt? Maybe a little discomfort. Take a Motrin before and you'll be solid!
- Below is a picture of what you should see on your ultrasound during the SIS. That black area is the saline in the endometrial cavity!
2. Hysterosalpingogram (I don't think they want to make these names pronounceable) also known as an HSG. You are awake during this one, ladies. HSG is an x-ray test to look inside the uterus. An HSG is similar to an SIS in the fact that they put fluid inside your uterus to evaluate.. this time the fluid will be dye and it will also be going through the fallopian tubes to assess if they are open.
- How long does an HSG take? Pretty quick test. Should be less than 30 minutes!
- How much does an HSG hurt? Holy Balls, I think it may not be the most fun thing you've done. I've never experienced one myself, but I also have never heard more ladies complain about a diagnostic test before. I do have one very tough friend who said it was really just severe cramping (but again she's a badass.)
- Since I said how much it hurts I'll follow with a positive.. at least you'll know if your tubes are open!
3. Hysteroscopy with or without tubal catheterization. This is the wham-bam-thank you ma'am of all diagnostic testing. This test is awesome because (at our clinic) you aren't awake during it! You won't feel a single thing thats going on!
- How long does a hysteroscopy take? This test can range in time. If there is something in the uterus such as a polyp/septum that needs attention it may take a little longer. Expect about 30 minutes to an hour.
- How much does a hysteroscopy hurt? Well you are asleep... so not much!
- Positives of the hysteroscopy are that it is the most extensive uterine cavity evaluation and they can check to see if your tubes are open, all while you have zero to little discomfort! You can experience spotting up to a couple weeks after though.
The steps prior to fertility treatments aren't the most fun, and can take some time to get done. Personally, patience isn't my strongest suit, but its important to try to practice some during the process. This testing will help to diagnose, and make a game plan that will get you to your goal! Happy testing, y'all!