QuestionHi Doctor, I have written to you before. I am 31 I have an almost 5 year old and a 3 year old, both conceived naturally the 1st attempt after stopping birth control pills. Decided to have a 3rd child, stopped pill in Dec 09, pregnant in Jan 2010 and 7 weeks in had a natural miscarriage (possible blighted ovum). Its now 7 months later and I am not pregnant, had hormonal blood work done and all looks normal. My OBGYN wants me to now have the HSG test done. I am really worried about this and don't understand why/how my tubes could be blocked. I have had 8 menstrual cycles since the miscarriage, every 26-28 days (they are very light, only about 3-4 days). What do you think is going on? My doctor said there could be a little mucus blocking the tubes, that this can happen and the test could help. I am so worried about this test and also concerned that they might find a problem.Would I be having normal near pain less menstrual cycles with blocked tubes and an easy conception 9 months ago? I am so confused. Thank you for your time and attention.
AnswerHello Jackie,
Your doctor is doing what most doctors do, which is try to do "something". You are correct that the HSG is not warranted. And, your doctor is correct that sometimes mucous can block the tubes and the HSG serves as a treatment to push out this mucous and restore tubal patency.
However, since it has been 8 menstrual cycles since your miscarriage, I wouldn't jump to the conclusion that something is wrong, or begin testing or treatment. In your case, your doctor is. In general, we don't labile a patient as having a fertility problem until they have been trying for 12 months. You may have gotten pregnant easily before, but it is not always the case. You could just have been lucky. My recommendation would be to continue trying using the calendar method for another 4 months. Then if nothing happens, begin an evaluation, of which the HSG will be one of the tests. At this point, there is no reason to suspect that your tubes are blocked unless you had an infection or something like that after the miscarriage.
Good Luck,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf
