The thing about this fertility journey is every other day you learn a new acronym or procedure that is a part of this journey. Before going to my RE I had no idea a Saline Infusion Sonohysterogram or "SIS" was even a thing. I had heard of the hysterosalpingogram or "HSG" which my regular doctor had recommended but no idea a SIS was a thing.
What is it you ask...
It is just how it sounds. It is an transvaginal ultrasound with saline infused in through the cervix with a small catheter to detect abnormalities in the uterus. Normal transvaginal ultrasounds can detect some abnormalities but this gives a clearer picture and can detect smaller things such as fibroids, polyps, and scarring.
This was one of the first things after bloodwork we had done after seeing my RE. Its done at a specific time in your cycle typically after your period but before ovulation, I can't remember the exact days. I was told to take some tylenol or advil before coming in as it can be uncomfortable. Being the hard headed tough person I am I didn't take any.
I got to the office and was told to undress from the waist down and given a sheet to put over me. The NP did my procedure as my doctor was out that day. She cleansed the cervix with betadine I believe and then inserted the catheter. She then injected the saline and I was able to see on the tv infront of me the whole thing, which being in healthcare is cool to me! When she injected the saline it felt like a sudden bad period cramp but it was not bad at all. I could tell their was something there on my uterus that wasn't suppose to be and I just felt defeated. ANOTHER hurdle to jump over. ANOTHER ultrasound that didn't bring good news! Every ultrasound is PTSD for me whether fertility related or thyroid related...its never good. The whole procedure didn't last maybe 5 minutes. The weird part is when you sit up all the saline rushes out of you into this like trash bag and it feels like you are peeing your pants haha. All in all wasn't a bad procedure at all. Pain was 1/10.
Afterwards the NP came in and told me she did see something on the ultrasound but wasn't sure exactly what it was more then likely a polyp. Again defeated and angry at this point. We were ready to start trying again that month and due to ovulate soon. All of that would be put on hold.
We had to wait for the RE to review the results to know our next steps. Being the anxious person I am I send her a message in the portal to try and get some answers. She was super responsive and responded back quickly and at that point we knew I would need a hysteroscopy to remove whatever was in there. Through the grace of God my RE squeezed me in the following week! I couldn't thank her enough! I wanted this taken care of ASAP and didn't wait to have to delay trying again. She put me on Aygestin which is a birth control to control the lining of my uterus and to make sure I didn't start my period. Let me just tell you Aygestin is the DEVIL. That little pill made me sooooo hungry ALL THE TIME. Thank God I didn't have to be on it long!
Thankfully Daniel was able to get off work for my procedure. He was on night shift that week so he ended up having to take 2 sick days. My hysteroscopy was done a UAB Highlands and we didn't have to be there super early which was nice. This isn't my first rodeo for a surgery so I knew the procedures. Get checked in, prep, IV, pregnancy test, vitals, and off to sleepy town you go. I may sound crazy but I love that feeling of anesthesia when they put you under hahah, best sleep ever...until I wake up usually nauseous. They had prescribed me a scopolamine patch to help with nausea as well. I don't remember much after the versed in my IV. The next thing I knew I was waking up in recovery, not nauseous, PRAISE JESUS! The procedure doesn't take long at all. I'm sure the majority of time I was under was positioning. I woke with what felt like a UTI soooo bad. The nurses said it was normal since the instruments were down there. When I finally saw Daniel the first thing I said was what did the doctor find lol. At that point he told me it was retained tissue from my prior losses. I was frustrated at that because I felt like I should have just had a d and c to begin with. I was frustrated my body didn't naturally miscarry or even fully miscarry with the cytotec! Gosh, come on body can you do something right please. I also had told Daniel when it was taking longer than expected to get a negative pregnancy test post miscarriage that I was worried about retained tissue and I thought I needed an ultrasound to make sure everything was gone. Apparently a regular transvaginal ultrasound may not have picked this up anyways.
Recovery wasn't bad. The worst part was that night I had really bad pain with urination and the urge to urinate frequently. It felt like I was peeing razor blades. Daniel went out and got me the over the counter uti meds and that helped some. They also called me in an antibiotic which eventually took that away. The post anesthesia I felt very anxious and tired but I couldn't sleep well at all. I'm so grateful my doctor recommended taking off that Friday after and the weekend and going back to work Monday. I felt like a zombie. I guess with my age I don't bounce back from anesthesia as quickly. I ended up taking magnesium with melatonin and that helped a ton.
My virtual follow up was fine and confirmed that I had retained tissue and actually a small polyp as well. We were given the green light to try again this next cycle and start progesterone vaginal suppositories 2 days after peak. My next step is either pregnancy or if not pregnant by June 17th I have bloodwork to confirm my elevated cardiolipin.
