Many of you have asked me about some of the tests I have had to do as part of our fertility journey. So as part of my promise to help educate infertility warriors and their communities about everything we go through, I figured I would start by sharing with you what a SHG is. I am starting with this procedure because I just had my third SHG done yesterday and it’s fresh on my mind (I am still feeling the cramps from it!).
SHG is shorthand for a sonohysterogram. It is a saline infusion sonogram. Still not 100% sure what that means? It’s basically a vaginal ultrasound where they shoot a bunch of saline into your uterus to give them a better look at it. If you are moving forward in your IVF journey, doctors will want to ensure that your uterus is in as perfect condition as it can be and this procedure helps them to view the uterus better than a normal ultrasound.
So here’s how it goes...you period starts (cycle day 1). Once your period ends (and before ovulation starts), you would schedule the SHG. For example, yesterday when I had mine I was cycle day 9. I didn’t have to worry about timing it before ovulation started because I am currently on active birth control pills to regulate all of that (don’t get me started on how awful birth control pills are! Maybe more on that in a future blog post). This timing, after the menstruation cycle and before ovulation, gives the doctor the best view of the uterine cavity during a SHG.
SHG’s start off like a pap smear - the nurse/doctor will insert the speculum into your vagina (hopefully they only have to insert this once for you. Yesterday, for some reason, the nurse had to keep readjusting it for some reason which became quite uncomfortable). Just like with a pap smear, they will use giant sized Q-tips to clean your cervix.They will then insert a catheter through your cervix into your uterus that will be used to inject the sterile saline solution. By inserting the saline into your uterus, they are able to expand it and allow them to take pictures (via the vaginal ultrasound tool that is also placed inside of you. I know...how many things can they fit in there?!). Normally, the uterine walls are “stuck” together so by filling it with the saline solution it allows the walls to move away from each other giving the doctor a better viewpoint. Just think of it like filling a deflated balloon with water. Oh yeah, and unlike other fertility diagnostic procedures, make sure you have an empty bladder for this! I learned that on my first procedure after getting undressed and preparing for the procedure only to find out via the vaginal ultrasound I needed to go relieve myself first. Oops!
Doctors will use the SHG procedure to search for uterine abnormalities. These abnormalities can include things like polyps (an overgrowth of cells in the uterine lining), fibroids (growth of muscle tissue in the uterine wall), or uterine adhesions (scar tissue) inside the uterus to name a few things.
I think the pain tolerance of this procedure differs for each person. I have had 3 so far since we started on our IVF journey in August 2018. During all 3 of them I am very uncomfortable during the procedure itself but not in any pain. The first 2 I had mild cramping and spotting afterwards...nothing that a nap and some down time at home afterwards couldn’t resolve. Yesterday’s though was a totally different story. Whether it was because she had to re-position the tools a few times and/or I was more tense during it since I was anxious for the results, I had pretty severe discomfort, cramping and spotting for the entire day afterwards. And FYI...you may leak a bunch of saline solution afterwards so definitely wear a menstrual pad to help with this (during my second one it literally felt like I peed my pants while we were driving home).
After the SHG, the doctor will review the results and if any abnormalities are found, determine the next step. After my second SHG (performed after my miscarriage so we could start moving forward in preparation for our next transfer) they saw what appeared to be a small polyp. My doctor said we could do a hysteroscopy (more on that procedure later) or wait another cycle to see if maybe it resolved itself. We choose to wait (since we couldn’t start transfer prep until the next cycle anyways). Yesterday was the follow-up SHG, and while the polyp they saw last time didn’t seem to be there, adhesions were present. So my doctor has recommended we surgically remove them in order to give my uterus the best possible chance for a successful next transfer. So that’s where we are at...I’m sitting here with some mild discomfort leftover from yesterday and trying to figure out how/when to get this hysteroscopy scheduled.
Just one more challenge for us to face in our infertility journey...
**This is not meant to be medical advice. Be sure to consult your doctor with any medical concerns. This is the account of my personal journey through infertility**
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