If her Dr is not communicating well I would really suggest she get a second opinion. There are fertility specialists out there who are genuinely caring and good Drs all at the same time. Graeme Hughes is wonderful, Devora Leiberman is also excellent.
At 9:48 AM +0300 9/5/06, Päivi Laukkanen wrote: >Thanks everyone for your help with the fertility issue. I received this >thorough explanation from Rebecca and forwarded all your answers to my friend. >She was very happy and relieved. She said it helps her a lot, that someone >actually explaines what all these procedures are for. She says the doctor >didn't even look at her or listen her at all. Now I now a bit more myself too. >So, thank you. > >Päivi > > > > >Hi Paivi, > >I am replying to you off the ozmid list, but please feel free to share this >post. I have 20 years experience as a natural family planning (NFP) teacher, >and would have to say that your friend is being offered "the usual" range of >investigations, and they are quite reasonable options, especially in light of >her history of an ectopic pregnancy (outside the womb, usually in the tube). >Even if the tube has been saved, an ectopic can really wreak havoc on the >reproductive organs, especially if the pregnancy was treated surgically. > > > bloodsamples for ovulation; >This is just a normal blood test that is mostly used to check her hormone >levels are healthy at different times of her cycle. It can be used to indicate >if she is ovulating (releasing eggs), which you could safely assume she is >seeing as she was pregnant! > > > take x-ray, where they spray the womb with some special color, which then > > shows in the x-rays. >As Jo said, this is called a HSG and they use a special (blue!) dye to fill >the cavity of the uterus. It should then flow up into and through the tubes >and out into the pelvis if all is well. It will show if the size and shape of >the uterus is healthy for pregnancy (maybe the last baby implanted in the tube >because there is a problem in the uterus) and it will show if her tubes are >healthy, free and clear (maybe the last baby didn't make it into the uterus >because there is a problem in the tubes). They can sometimes push the dye >through the tubes pretty hard, which can be a good thing as it can 'unblock' >them and sort of 'clean them out' a bit, but of course it can't 'unblock' scar >tissue. Many women report conceiving in the couple of months after a HSG and >think it has a theraputic value, but there is no research to support this and >it really is a diagnosic tool. It can be a very painful proceedure at the >beginning (to dilate the cervix a little to allow the instrume! nts through) but the rest of the proceedure is not usually painful but might can sometimes be a little uncomfortable. Sedation is usually used, and it is often done under a general anesthetic with other proceedures (see below!). Afterward, there can be a little crampy feeling, but usually there is not much at all. > > > some kind of operation to see the scar from the previous unsuccesful > > pregnancy. >This would be a laparoscopy (or a "lap"), where they put instruments through >the abdomen to actually look directly at her uterus, tubes and ovaries. This >is a visual inspection of her anatomy, and will reveal the extent of any scar >tissue, adhesions and the like from the ectopic. This is done under >anesthetic as a day proceedure. The 'big cut' from this proceedure is about >1-2cm, along with a couple of 'puncture marks' that are very small. I don't >think they even stitch any of these any more... they usually don't even scar. >Afterward the tummy can be a bit tender, and you can get a very nasty pain up >under the left shoulder blade (they fill the belly full of gas to separate the >organs and see them better, and if this gas is slow to be absorbed by the body >a 'pocket' of gas will collect and irritate, and the pain is felt in the left >shoulder. It can be very intense pain - I actually needed pethidine!) > >> They would also scrape the womb and take some "samples" to see if her body >> is doing what it's supposed to. >This is called a dilation & currettage, or a D&C. The dilation refers to the >cervix, again this is a small dilation required to allow instruments to be >passed into the uterus, and a currettage is a spoon-like instrument attached >to suction that would actually 'scrape' away some of the surface lining of the >uterus (which she would have shed at her next period). This is sent to >patholgy for anaysis, and reveals all kinds of details about her hormone >levels and reproductive health. There may be a little spotting for a couple >of days following a D&C, but again there is not usually very much at all. > > > If they find problems the doctor suggested ivf next. >This is where I think we may suddnely jump over into "unreasonable" options! >If the lap, D&C, and HSG all indicate that she is well and healthy then it >would be reasonable to investigate more natural, less invasive assistance to >achieve another pregnancy - and certainly learning about her fertility and >charting her cycles could help her. She could contact the Australian Council >of Natural Family Planning 1800 114 010 for an accredited NFP teacher (sadly >there are a lot of quacks in NFP!!) and she might also look at naturopaths >etc. If however there is a mechanical problem or blockage with the tube, then >she is really looking at needing more medical assistance - this may mean true >full on IVF, but there are all sorts of other treatments that may be lumped >under that banner and she really needs to know exactly what her problem is to >know what her options are. > >Certainly a lap, D&C, and HSG are invasive, but they are not particularly >aggressive (in so far as what could be done!) and they are a good set of >diagnostic tests. There are no 'althernate therapies' that will give her this >kind of information. Once she knows 'where she stands' she can make a true >choice about her options. I wish her the very best of luck. > >Beck. > >Rebecca Hart, Midwife & Natural Family Planning Teacher > -- Jo Bourne Virtual Artists Pty Ltd -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
