Bilateral hydrosalpinges – a serious road block.

The moment I left the ultrasound I typed “bilateral hydrosalpinges” into Google – my heart racing at the anticipation of what I would find out (I prayed there would be good news – maybe she was wrong, I’m sure there’s an alternative to IVF). Before that moment I had never even considered what I thought about assisted reproduction. I wasn’t against it but it seemed so distant from me (and expensive and emotionally exhausting). The first time I googled the diagnosis (sitting in the car outside the clinic) I found myself in a perpetual state of panic – trying to focus on the information but each sentence triggering further panic. I am not a crier – but I was sobbing uncontrollably.

The prognosis seemed bleak. Hydrosalpinx (singular) basically means there is fluid “hydro” in the tube – due to the fallopian tube being blocked at the distal end (the end closest to the ovary), usually from past infection causing inflammation and scar tissue. The delicate fimbria at the end of the tube often become fused together. Because the tube is blocked at the distal end, there is nowhere for the fluid to go. The tube becomes swollen and distended.

People can still fall pregnant naturally if only one tube is blocked – however the chances are significantly reduced. However, mine is bilateral (both sides). Meaning the egg and the sperm can never meet.

Worse news – “ultrasound visible hydrosalpinx” have a poorer prognosis for surgical treatment. Mine were both clearly seen on the ultrasound. And although one was “small” the other one apparently was much larger and most likely adhered to my right ovary.

Surgery to open or fix the tube has a poor success rate (for cases of hydrosalpinx at least – there are other types of tubal blockages that are more successfully fixed).

There’s still hope to get pregnant– but probably only with IVF. And if you have hydrosalpinx your chances of IVF being successful is reduced by about 50%, while your chance of miscarriage goes up by about 50%, compared to those without hydrosalpinx. The proposed explanation is that the fluid from the hydrosalpinx can leak back into the uterus and either; (1) is toxic to the embryo and/or (2) the fluid washes away the embryo and disrupts implantation.

The solution – the gold standard these days appears to be removal of the hydrosalpinx (which means removal of part of the fallopian tube). In the past, especially before IVF, doctors tried to open the tubes. But the success rates were very low (I believe around 10% depending on the size of your hydrosalpinx). Since IVF came about – it is much more effective and efficient to remove the tubes and go directly to IVF (according to my research and both specialists I have seen).

So, I am panicking – I am trying to read all this information and take it in, while at the same time forgetting how to spell ‘hydrosalpinx’. It is all so fresh. I keep getting distracted by thoughts “I’m healthy, I’ve never had symptoms”, “How can this happen?”, “It’s not fair”, “I won’t cope”, “What if I can never have a baby?”.

Panic. Crying. Researching. More panic. Back to researching. Frantically trying to read something that would make me feel better. Those first few days – it seemed the more well informed I became, the greater sense of hopelessness and dread.

Finding out about infertility.

I honestly thought the ultrasound was probably premature, but I am a proactive person. And I thought it would give me reassurance (yes your reproductive anatomy looks great – go home and keep trying!). It certainly started out that way “this is your uterus – look at the beautiful shape”, “perfect lining, what we would expect at this time of month”, “here is your left ovary… looks like you ovulated from your left this time!”, “I think you also ovulated from the right” (I breathed a mental sigh of relief as I heard of people who don’t have ovaries). After that point I relaxed. Then, her positive, upbeat reporting of my perfect anatomy ceased. She started focusing intently, muttering “mmm some fluid there” – to be honest I tuned out a little (I was still thinking about how I ovulated from both ovaries – I could have had twins this month!). She finished up the procedure – telling me “you have fluid in both Fallopian tubes, the next step is to book in with an IVF specialist”. I couldn’t understand what she had just said – confused I asked “You mean I can’t get pregnant naturally?”, “Sorry, not based on what I’m seeing”. I must have looked shocked because she rubbed me on the back.

She then gave me a printout of the ultrasound report and sent me on my way – I read it on the way back to the car – this was the first time I read my diagnosis “bilateral hydrosalpinges”.

I can only describe that moment as heartbreaking and accompanied by a sense of dread. I am not a dramatic person, but it reminded me of the feeling you might get when you here a loved one has been given an unexpected diagnosis of cancer. Followed by a roller-coaster of emotions that I would normally associate with grief (shock, anger, denial, sadness, and later acceptance).

Before infertility – the ignorant bliss of casually “trying” for a baby.

This is a blog about my journey with infertility. It started in May 2017.

I guess a brief back story would be helpful. I always knew I wanted to have children, and like most people just assumed after deciding it was the right time, it would happen without much thought or effort. I had never had any gynaecological issues (not even period pain!). Most people I knew with children said things like “It happened the first month”, “we hadn’t really started trying”, “we were so surprised!”. And the very few examples of people I knew who had difficulties had still fallen pregnant after 18 months or so (I remember briefly hoping this wouldn’t be me, but ignorantly thinking it probably wouldn’t). I’m a scientist-practitioner (clinical psychologist), so I was reassured but the statistics that most people fall pregnant within 6 months of trying (around 70%). So after getting married in early 2016 at the age of 28, to my long term partner of 7 years (he was 34), and both of us having established careers, we thought it was the perfect time to stop using contraception and “just see what happens!”.

After 6 months of “casually trying” with no success we move on to another 6 months “actively trying” (i.e., charting, tracking, OPKs, and generally overanalysing any bodily symptom). For those who have gotten to the active trying point (some get there quicker than others)– you will empathize with the process (it’s not fun and can take a mental toll on you very quickly). My anxiety was gradually building and I had reached the point where, statistically, 85% of woman my age should be pregnant (around the 12 month mark). I decided to see my GP. She ordered blood tests (FSH, Progesterone, LH, TSH) and to be thorough, gynaecological ultrasound. The hormone levels were all in the normal range so I went off for my ultrasound…