HSG xray and HcG trigger shot, need advice

[Anonymous]

I've recently taken the step and gone to an RE (at CFA). I'm trying to get an idea of what to expect for my upcoming HSG xray and the timing of the trigger shot. I'm also doing a clomid challenge test. I'm going in early next week for my HSG and later in the week to see if I have mature folicles and if so, they say they'll tell me when to trigger. So my questions are -
- how much discomfort did you experience with the HSG procedure? I usually take metro, but should I plan on having DH drive me home?
- does the trigger shot usually happen the same day as the sono? if not, how soon after?
- assuming we have to try a few times, will I go in every month for a sono to see when I should trigger or will they estimate the days another way? trying to figure out costs for office visits, etc...

Thanks for your help!

[Anonymous]

HSG pain varies. I have had little to no pain, while others have had extreme pain. I took 800mg of Advil an hour before and really think it helped. If you do a quick search on this site for hsg, then you will find some recent threads about people's experience with hsg pain.

Your trigger shot is completely unrelated to the hsg. The shot is done as you get close to ovulation, so if you have an idea of when you ovulate from using OPKs or temping then you can gauge when you might trigger. And, you may ovulate a little later this month since you are taking clomid. I know that I was a few days late ovulating when I did the clomid challenge test.

Frequency of monitoring will be contingent upon the type of IUI you are doing. If you are not using injectable medications, then you may only have u/s done a couple of times in a cycle. If you are using injectables, then you will be going in much more frequently based on how you are responding to the drugs. Some clinics offer a single price for a complete IUI cycle that can help manage costs. I am not a patient at CFA, so don't know if they do.

[Anonymous]

I am a patent at CFA and do IUI with injections and trigger shot. A typical cycle looks like this.

CD1: Call the office to let them know you started you period
CD3: Go in for bloodwork and sono to check you hormone levels, uterine lining and folicles
That afternoon they will call to give you instructions for your injections...start injections that night
CD 5: Go in for bloodwork-adjust injections if needed
CCD 7: Go in for blood work and sono-adjust injections if needed
CD 10: Bloodwork
CD 11-12: Go in for sono to determine how many folicles you have, how thick your lining is, and how mature the folicles are. On injectible cycles they like to see 1-4 mature follicles, measuring 18-21mm.
CD 13-14: They will have you use the HCG trigger to induce ovulation

If you are having one IUI they will have you come in 36 hours from the trigger shot for your single IUI. If you are having back to back IUI's you will have the first at 24 hours post trigger and one at 36 hours post trigger.

One week after trigger you will go in for bloodwork to check your progesterone levels to ensure that you did ovulate.
One week after that you will go back in for your HCG beta test...hopefully you're pregnant!

[Anonymous]

This the previous poster...
I've been through two rounds of injections with timed intercourse and one round of injections with single IUI...it hasn't worked for me yet...but I'm still positive.

[Anonymous]

OP here - we're not doing IUI, just timed intercourse. And I'm only doing clomid and the HcG shot right now. I know that the HcG and HSG are unrelated, I'm just trying to get info on both with one post.

I don't ovulate on my own, so we definitely need the sono to tell us if it is time for the trigger. Should I expect to do the trigger shot the same night as the sono or the next day?

[Anonymous]

For TI, most clinics have you check for your LH surge and then come in for u/s. Since you indicate that you don't ovulate, then not sure if OPKs work for you. If they do, then you should only have to go in the day that you surge for u/s. If they don't work, then you may have to go in a couple of times in your cycle for u/s to determine when you should trigger.

[Anonymous]

If you're doing the clomid challenge test for insurance purposes, fake it by not taking the clomid. Most REs don't use this test anymore given that they can look at FSH, AMH and AFC. This is especially true if you're just doing IUIs - the test really isn't relevant. Insurance companies use it to kick women off their coverage rolls.

[Anonymous]

Regarding the HSG, I agree that it varies from person to person and it is definitely recommended to take some Advil beforehand. I feel that really helped. The procedure was actually pretty quick and painless for me. The dye just felt like a mild menstrual cramp and then it was over pretty quickly. After that I had no pain at all. My doctor even laughed when I said, "that's it?" As for going home on the Metro, you probably can. However, that depends on how you personally react to the test. I could have taken the Metro home but I know a few women who experienced more pain than I did. Just be prepared that you will spot or bleed a little, so make sure to take a pad with you. Since you don't know how you are going to react, I would be on the safe side and have DH drive you home. Hope that answers your questions.

[Anonymous]

Anonymous wrote:If you're doing the clomid challenge test for insurance purposes, fake it by not taking the clomid. Most REs don't use this test anymore given that they can look at FSH, AMH and AFC. This is especially true if you're just doing IUIs - the test really isn't relevant. Insurance companies use it to kick women off their coverage rolls.

I don't understand why I would do this. Do the challenge test but don't take the clomid? Or are you saying not to take the clomid at all? I've done 3 mo unmonitored on clomid previously, so I think it would be helpful to know if I'm responding. Also, I think since I've already done clomid, I won't worry about my insurance kicking me off.

Also, we're not doing IUIs, just timed intercourse.

[Anonymous]

Anonymous wrote:I've recently taken the step and gone to an RE (at CFA). I'm trying to get an idea of what to expect for my upcoming HSG xray and the timing of the trigger shot. I'm also doing a clomid challenge test. I'm going in early next week for my HSG and later in the week to see if I have mature folicles and if so, they say they'll tell me when to trigger. So my questions are -
- how much discomfort did you experience with the HSG procedure? I usually take metro, but should I plan on having DH drive me home?
- does the trigger shot usually happen the same day as the sono? if not, how soon after?
- assuming we have to try a few times, will I go in every month for a sono to see when I should trigger or will they estimate the days another way? trying to figure out costs for office visits, etc...

Thanks for your help!

Our situations sound similiar except that I went to Shady Grove.

The HSG did not hurt me at all. But, have DH with you and then drive you home. More for moral support than anything.

When you have the sono and/if it's determined that you have enough eggs ready (but not too many) then yes, you go home and do the trigger shot, and then intercourse for two nights, we were told.

We had to go in for sonos every time before the trigger, dont' want to have too many eggs there and end up with a Jon and Kate situation!

Good luck! I'm now watching my twins play together and it's wonderful!