Infertility and testing go together like peanut butter and jelly (or peanut butter and marshmallow fluff, depending on where you’re from). The tests start roughly around the one year mark, when you bring up to your doctor that, hey, we’ve been trying to fulfill our biological imperative and propagate the species for about a year now, but no dice. What gives?
These tests fall into one of two basic categories: giving someone else your bodily fluids or having things shoved delicately inside of you to take a peek around. The latter is usually the less pleasant option, if only because it takes a lot longer, but the former can be an adventure, too.
In terms of giving someone else your bodily fluids, the ovary-haver usually only needs to offer two types of fluid: blood and urine, like this is some sort of terrible German porno. The blood work has to happen about once a year, and it’s a LOT of blood–my most recent testing required a grand total of ten vials, and six of them were for fasting bloodwork (in other words, I was going in there with no food or drink in my body). The urine–I’m not really sure what they test when you pee in a cup, to be honest, but once you’re pregnant, the cup peeing becomes a monthly and then weekly and then daily thing, so if nothing else, I figure it’s just to get you used to it and help you develop your technique.
(tip: aim better than this)
The sperm donor has to contribute blood as well, but he also needs to have his semen analyzed. This particular facet of testing is ripe for comedy because there is no way to make wanking for the spank bank not funny. In the best of times, a fellow can make his contribution in a pleasantly lit room at the infertility clinic. This room is, inexplicably, soundproof. The best clinics have rooms with sterile furniture; the worst clinics have wicker, of all things. They all have magazines with the covers torn off and DVDs of questionable content.
I won’t go into detail about the worst of times.
When we first started testing, way back four years ago, the clinic actually refused to give us the results of Kyle’s test because he didn’t yet have a primary care physician in Massachusetts (long story short, we had very bad insurance back then). He had to go through the whole process a second time (this clinic did not have a room, so he had to bring his donation with him, tucked under his arm to keep it at body temperature), and we still didn’t know the results until we reached this IVF adventure.
(his results: A+ quantity, but very poor motility and morphology–a.k.a., the guys are drunken mutants, the wrong shape to fertilize a single egg, if they could even find it)
But fortunately, that’s where the testing ends for the sperm donor. For the ovary-haver, the testing has just begun; because, you see, sperm donors don’t need to have anything delicately shoved up their danger clam. Ovary-havers? We do.
There are three basic “things inside you” tests (in order from least horrible to “WHY WOULD YOU DO THIS TO ME?”): the sonohysterogram, the hysteroscopy, and the hysterosalpingogram.
The sonohysterogram is entry level invasive junk testing. In this test, a tech fills your uterus with a saline solution in order to check your uterine lining for abnormalities that wouldn’t otherwise be seen on an ultrasound. The test takes a grand total of five minutes and is less unpleasant than it is just very wet. At my last one, the tech told me to think of it as a spa treatment, maybe like yoni steaming or something like that. I’ve never desired to try yoni steaming, and the combination of that metaphor with the weird “seashore” sound effects she played during the procedure just made me uncomfortable.
(if you’ve never heard of yoni steaming, it’s basically perching with your lady bits over boiling hot water for like. Gwyneth Paltrow reasons or something)
But as the tests go, the sonohysterogram is easy as pie. You get in, you get splashed, you get out. Boom, boom, boom.
The hysteroscopy is a little more involved, because it requires a camera. With a hysteroscopy, your doctor inserts a light and camera to have a look around the inside of your uterus. This is never not weird. It’s a relatively painless procedure; maybe there’s some cramping because there’s a camera in your uterus, but all in all, it’s not bad. At my last hysteroscopy, my doctor even let me watch the monitor that showed the inside of my uterus (I told her, I wanted to look my uterus in the eye after all it had put me through). Truth be told, it was less red than I expected. It looked more like a pale piece of undercooked chicken, which is apparently normal. And I suppose that makes sense, but after twenty-something years of periods, I expected more carnage.
(more Carrie, less Food Network, really)
But the hysteroscopy and the sonohysterogram pale in comparison to the worst of them all: the hysterosalpingogram.
On paper, it sounds simple. They squirt dye into your cervix and uterus, it travels up your fallopian tubes, and then they take an X-ray of the whole system to make sure nothing is blocked or broken. The dye then leaks into the rest of your abdomen, where it presumably makes your internal organs look really funky. Easy, right?
No, no, no. This procedure is terrible. It starts the morning of, when you take a huge antibiotic pill–one of those ones that kills e v e r y t h i n g–and that makes you sick to your stomach. Shortly before the procedure, they give you hospital grade Tylenol to dull the pain, but this does exactly nothing except make you mildly loopy (if you’re me, at least, and get loopy at the suggestion of medication).
You go into a weird sort of OR for this, and I say weird because it’s a radiology lab, so it’s very different from the pleasant OB/GYN offices you’ve been visiting all along. Everything seems normal, though: you put on a johnny and lie down on a cold metal table. You put your legs in stirrups, and someone explains what’s going to happen. The doctor tells you, “Whatever happens, don’t move,” and that sounds easy enough.
Then comes the speculum and the iodine to clean your cervix, and so far, everything seems normal. Even the dye tube seems normal at first, but then they squirt the dye in, and I will tell you that this ranks third in worst pains of my life (first was gallstones, second was when my epidural didn’t work when I was giving birth to Sam). It would have ranked higher, except it doesn’t last very long. It’s a fiery, cramping sensation, not entirely unlike menstrual cramps, but much more sudden and much more severe (and for those who’ve never experienced this level of menstrual cramping, imagine the cramps you feel when you’ve got severe diarrhea, and then multiply by about ten).
And you’re not supposed to move. Every instinct in your body tells you to curl up and fight this pain, but you cannot move. At all. They take an X-ray of your abdomen, and then it’s over, but the pain lingers in the back of your mind, to the point where you can’t help but say, “I’m so sorry,” if anyone ever mentions a hysterosalpingogram in your presence.
That’s one of the silver linings of IVF, too: it doesn’t matter if your fallopian tubes are blocked. You don’t need to have a hysterosalpingogram. You can just go on with the sonohysterograms and the hysteroscopies and be happy about your life because your life does not involve hysterosalpingograms anymore.
Anyway. Today is a testing day. Kyle did his testing this morning, and I’m heading in for a hysteroscopy after lunch. Fingers crossed it’ll show that we’re free and clear to keep moving forward.