Infertility: The Saline Ultrasound Appointment

Have I not commanded you? Be strong and courageous. Do not be frightened, and do not be dismayed, for the Lord your God is with you wherever you go.”

Joshua 1:9

July 1, 2019

This was the day of my SIS appointment. The SIS is a saline infusion sonohysterography or saline ultrasound uterine scan that uses a small amount of saline (salt solution) inserted into the uterus to allow the lining of the uterus to be clearly seen on an ultrasound scan. When Dr. D described this to me, it sounded like the HSG x-ray I had back in 2017, so I mentally prepared myself on the days leading up for what to expect at this appointment. Joe offered to come with me for moral support, but because it was going to be a quick thing and I had had uterine ultrasounds in the past, I didn’t think it was necessary for him to come.

When I arrived at FINA (Fertility Institute of North Alabama) I was greeted again by my favorite receptionist and soon after checking in I was called back by one of my favorite nurses (everyone there is my favorite lol). She told me the drill, take off everything from the waist down, use the thick paper blanket to cover myself and the doc would be in shortly. When Dr. D came in he explained the procedure to me again, that it would feel very similar to the HSG and I might experience slight pain and/or discomfort, like cramps.

The Screen

Dr. D encouraged me to look at the screen so he could explain what we were looking at and answer any questions. Throughout the ultrasound he asked me to let him know whenever I felt pain. The pain question is always so hard for me because I have a high pain tolerance and I find it so difficult to measure my level of pain. Although I may feel slight pain it’s not terrible or excruciating so I often feel like it doesn’t count. But Dr. D said, “even if it’s slight pain, let me know so that I can make note of it.” So, every time he moved the ultrasound stick and it hurt even the slightest bit, I let him know!

When it came to the image of my uterus on the screen, he could see what looked like fibroids and he suspected possible tube damage based on the past suspicion of damage (even though the HSG showed the tubes being clear) and what he could see in the ultrasound. He and the nurse, who was holding the saline solution, started with their medical talk lol and I pretty much tuned out after that and began focusing on my breathing (that doggone ultrasound stick is not fun lol). After they were done, they allowed me to get dressed so Dr. D could return.

The next step

Dr. D explained the things that he saw in the ultrasound, the main concern being hydrosalpinx, which is a blocked/damaged tube. He, of course, wouldn’t be able to diagnose that until the laparoscopic procedure but this kind of changed the course of treatment. He told me that in addition to the laparoscopy he would also have to do a hysteroscopy. Hyster – what??? (I just heard hyster and my mind went to hysterectomy). The tears began to fill my eyes and I know he could see it. I tried to hold them in long enough for him to finish what he was saying. He proceeded to explain the hysteroscopy, which is using an endoscopy (a very tiny camera on the end of a flexible tube), will be done to look inside the uterus. Whew! Okay! I could live with that. He said that if there is endometriosis he would remove that, depending on the size of the fibroids he may or may not remove those, and if I do have hydrosalpinx he would remove that blocked/damaged tube. He immediately asked me how I was feeling. I told him, “overwhelmed. This is a lot.” He said he knows all of this is a lot, but he wants me to be aware of all the possible outcomes and the steps we need to take. His concern at that time was addressing the pain.

Dr. D then briefly mentioned IVF (in vitro fertilization). He was honest in saying that he believed he would have to remove one of my tubes if not both and that IVF would be the next step for pregnancy. He asked me what my hesitation was with IVF and what I knew about it. I told him the entire process was terrifying – everything including the cost. He said the cost is most people’s concern, but that FINA takes care of their patients and helps find the best possible financial solution for each family. He said he wanted to schedule a meeting with me and Joe after the surgery to discuss IVF if necessary. He said that he wanted put my mind at ease with all of that, but that we would cross that bridge when we got there. The fact that Dr. D brought up IVF was an indicator that that would be our route for pregnancy. I felt it in my gut at that moment, like God preparing my mind because He knows His daughter, but I didn’t dwell on it much because I was still claiming a different outcome.

The uncertainty

Leaving that appointment had me feeling so anxious but I also had a little hope somewhere deep down inside. I called Joe as soon as I got into the car and told him everything that happened. It’s so funny because I always wait for Joe to have an “oh no! What are we going to do?!” response, but it’s never that! I’m on the phone feeling somewhat overtaken by emotions because in the back of my mind I’m already expecting what I don’t want to happen, and Joe’s response is “we got this!” As women sometimes we want men to respond with as much emotion as we do to certain things to help justify our emotions, but it rarely happens like that, if ever. Thank God He didn’t make men and women alike because Joe’s response is exactly what I need. While I’m freaking out, anxiety-stricken and in tears, I need him to remind me that we got this and that God’s got us! When I’m feeling like I’m not strong enough to go any further, I need him to remind me of the giants I’ve crushed and lived to testify about. When I’m feeling completely out of control, I need him to remind me that even though we are uncertain about what’s going to happen next, we are certain about God’s promises. I’ll be saying this a lot… thank God for Joe ?

This whole process thus far has been challenging to say the least. The blood work, the results, the ultrasound, the testing, the appointments, the co-pays – it’s all so much and literally exposes my anxiety and fears. This is just the beginning and this journey is already testing my faith, my strength, my patience, and my confidence – everything I feel like I’ve been working on for the past decade and God’s like, “alright, we’ve spent all this time working in these areas of your life, now it’s time for the test.”

Even though this whole process and what’s to come is terrifying, like I said before, there’s a small bit of hope that I cling to for dear life. The next step is the surgery and I’m honestly looking forward to that because it’s one step closer to God’s promise. Until next time…

Live well,