Hello, Sunshine.
ASM, I did have an internal ultrasound. That was the first step. They found a polyp in my uterus, which is on the large side and in the "sweet spot". My RE told me that it could be acting like a natural IUD - preventing implantation. I'm not sure that they could even see my tubes during the ultrasound, so I don't know what having an ultrasound could have to do with the HSG. In fact, the HSG isn't even 100% indicative of problems if I understand it correctly. That's why they suspect I have endo, rather than coming right out and saying I have endo for sure. The only procedure that can diagnosis me for sure is the lap surgery. Which I'm having the at the same time as the polyp removal. So, at the same time they would be able to diagnosis me for sure as having endo, is the same time they will fix it, if that is possible.
As for insurance, ours isn't great either. In fact, it only covers diagnosis, and not treatment. So while the HSG is covered, if I was having the lap just for fertility reasons, it would not be covered at all. Problem, because it's expensive. In fact, I didn't even ask how much it is, because no matter what I want to have to have it. So I may as well find out the cost later, since we feel it's non-negotiable.
However, when I said before I wasn't symptomatic, I actually had things going on, I just never related them to my reproductive system. Does that make sense? Now that I know about the hydrosalpinx, a lot of what has been going on with my body makes much more sense to me now.
For example, about 3 years ago my cycles became longer and heavier. I started clotting more. Like, big, big clots. I chalked these things up to age and personal history. Every 8 years or so, my whole life, my cycle has gone through some kind of major shift. I just thought I was amidst another change. Also about 3 years ago, I began having trouble going to the bathroom. I feel constipated a lot of the time and frequently have trouble going to the bathroom. I don't have any real pain, just "trouble". Also around 3 years ago, I began feeling some pressure in my right side. I thought I had an obstructed bowel. In fact, I have had x-rays and ultrasounds trying to figure out the bowel thing for a long time to no avail. I just thought it was my body and I'd have to learn to live it. I now rely heavily on a hot water bottle to help ease the discomfort - which is something I never had to do before.
Well, now I know that pressure isn't an obstructed bowel, it's my right f-tube! So those reasons alone should help cover some of the costs of my surgery. I had a frank talk with my doctor about our insurance coverage and how strict they were with fertility coverage and that really helped. We talked about the many different ways she could code it. If I do indeed have endo, which she is certain that I do - it just can't be diagnosed by her office without the lap, then that will help too, because even though removing it will help us get pregnant, it will reduce my flow, my clots will be different once the polyp is gone, and frankly, the insurance company can't stop me from receiving benefits for the surgery if it helps with other conditions - so there you go.
The point is, I was so sure I had bowel issues and not reproductive issues. Partly because my cycle is so regular, I O on time, my Day 3 tests were wonderful (have you had those?) and my husbands SA became acceptable, I've never had an injury, no STD's... you know. Tubal issues were the LAST thing on my mind.
During my cycle I sometimes have cramps, and sometimes not, but I did play them up a bit, because it gives her another reason to use a different kind of code. I know that may seem dishonest, but while I feel like I can handle the cramps and wouldn't have sought out treatment for them generally, I feel like I should tell her everything, even if it seems minor, and let her make the judgment on how it's reported.
The truth is, it can be really hard to get a diagnosis. My DH and I have not prevented pregnancy for the past 8 years. It's true that we haven't exactly been trying that entire time either, but still - no BFP for me. And even with the pylop, endo and tube, no one has said I'm infertile or going through infertility. Hopefully because all of my issues are treatable. After they are all gone, if I still have trouble getting pregnant, I guess that will be another story. And I'm sure it would be even hard to give you a label or diagnosis without ruling everything out, and they can't rule things out if you're not checked out, right?
If you are really looking for things to "work on" to help you get pregnant, there are other things to try aside from your doctors visits. You could see a recommended Traditional Chinese Medicine (TCM) practitioner and get a work up from them. They will usually tell you something after a simple examination and then you will have something concrete to work with. I went to one and was amazed at what she told me. About being hot vs cold etc. She also gave me some herbs to drink like tea and that made me feel proactive. There are also countless books which will have general advice, yoga for restoring fertility and all kinds of things that may give you some kind of direction.
I know it feels so rough JUST NOT KNOWING and that it can be especially tough if you're actively trying to get pregnant. But just know there are lots of ways to help yourself, without a doctor. After all, what's the worst that could happen from doing some yoga?
As for your DH's SA, I was told that one sample isn't enough to get a complete picture of any MF (male factor) issues. That most labs need 3 samples over time and then create an average. My DH's first test had him with 8M sperm. His second test he had 38M sperm. Go figure. Still not HIGH, but acceptable. Thanks vitamins! We didn't even do the 3rd one. When we had our first IUI he reported good numbers then too, but they didn't share them with us.
I wish you so much luck and I encourage you to keep posting. If you have any other questions about my own experience, I'd be happy to answer them. I hope you have a great week.
Xo, Charley