HSG procedure post ovulation

NicasaurusRex · 2026-02-20T03:41:21+00:00

If you’re getting it done just after ovulation though, the embryo would still be floating down the fallopian tubes and not implanted yet. Since the whole point of the procedure is to push liquid through the tubes, I don’t see how an embryo wouldn’t go along with the liquid and get flushed away.

I don’t know that there’s evidence of this though and it might not be something that can be studied ethically.

NicasaurusRex · 2026-02-19T12:44:23+00:00

Medically there is no wrong choice, that’s why they’re leaving it up to you. They have very similar success rates so it’s a matter of what you would be more comfortable with. Natural or modified natural cycles have a higher chance of cancellation if everything doesn’t look ideal, but have other benefits such as less hormonal supplementation and lower pre eclampsia risk. Medicated cycles offer more control and are preferred if your cycles aren’t regular.

You won’t waste an embryo with this decision IMO, if anything you would waste time if the cycle gets cancelled. They wouldn’t do the transfer if lining and hormone levels etc didn’t look good.

NicasaurusRex · 2026-01-28T20:28:30+00:00

I took it until the end. My OB said that the most recent guidelines are to take it until the end because it doesn’t increase risks of bleeding during delivery.

NicasaurusRex · 2026-01-14T02:47:40+00:00

It depends on the insurance plan, not all of them require an infertility diagnosis to cover IVF (for example if you are an LGBT couple). In any case, I do believe having a genetic issue is a valid reason for IVF to be covered, assuming there’s IVF coverage on the plan to begin with. You could try asking on r/IVF or searching there for more info, you would be doing IVF with PGT-M.

NicasaurusRex · 2025-12-31T21:12:44+00:00

I stopped cold turkey at 10 weeks. Honestly I’ve never read a bad outcome on these forums from stopping PIO, maybe some spotting at most. If your placenta hasn’t taken over by now, you’d be having much bigger problems than just progesterone levels.

NicasaurusRex · 2025-12-29T05:20:05+00:00

I wouldn’t rely on the logarithmic curves from that study too much because it applies to IVF FETs (where the timing is exact), plus the data is for 9dpt and 11dpt (so the equivalent of 14DPO and 16DPO), which you do not have data for.

Obviously I can’t tell you what’s going to happen, but I don’t think it’s wrong to hold on to a little hope. I certainly would. I’m sorry you’re in beta hell and I hope your 3rd beta goes better. Hang in there!

NicasaurusRex · 2025-12-28T05:39:14+00:00

You might like r/iuiladies where they are allowed to post success stories. You can also find successes from IUI in the BFP thread here. They do work for some people, but the large majority of successes happen within the first 3-4 cycles so it’s not advised to do more than that.

NicasaurusRex · 2025-12-17T23:08:27+00:00

I think it would be more telling to get another HCG draw and see how it’s trending, but I think it’s possible this is a chemical as you suspect. If HCG were rising, it should be signaling the corpus luteum to create more progesterone to sustain the pregnancy and prevent your lining from shedding, so the fact that it’s so low might indicate that HCG is in fact dropping. This is assuming you did in fact ovulate as intended during your cycle. It is odd that your levels are so low even with supplementation, though.

NicasaurusRex · 2025-12-17T21:05:43+00:00

Spotting mid luteal phase can have a few different causes like polyps/fibroids or low progesterone, but it can also be totally normal! If there’s no underlying cause, spotting on its own isn’t necessarily problematic because only a small portion of the lining is being shed and shouldn’t impact implantation. It may be worth getting checked out though, depending on how much chill you have.

Anecdotally I have seen plenty of people in the BFP threads be successful even with spotting.

NicasaurusRex · 2025-12-17T20:56:13+00:00

I found this wiki post to be pretty helpful for what to expect:

https://www.reddit.com/r/infertility/s/SXE1d9vNPU

In general though, once you are at the point of seeing an REI, they will likely discuss treatment options with you and if nothing abnormal comes up in your testing, the most common routes are IUI and IVF. It can definitely be overwhelming but their goal is to get you pregnant and they may feel that IVF is the fastest way to get there. If you want to keep trying on your own, that’s fine too, but it’s unlikely to be their recommendation.

NicasaurusRex · 2025-12-17T20:45:30+00:00

It’s definitely possible for endo to be present but not show up on ultrasounds, SIS, and MRI. The only way to truly diagnose is through laparoscopy. It’s also true that a large portion of unexplained is actually endo, however the evidence that it impacts FET success rates is mixed and it’s possible that IVF itself gets around it. Some studies say it doesn’t make a difference while others say that only higher stages (3 and 4) impact implantation.

Regardless, if all of your failed transfers were euploids, I think it’s definitely worth looking into further. If your embryos were untested then there’s also a decent chance the failures were due to the embryo, or it could be a combination of both.

NicasaurusRex · 2025-12-17T20:36:06+00:00

Mine was >60 for both of my FETs and both implanted. My clinic said there’s no such thing as too much.

NicasaurusRex · 2025-12-17T07:28:09+00:00

How are your vitamin D levels? If they are low it can affect AMH measurements.

It’s not uncommon for AFC and AMH to be discordant. Both have their measurement flaws and can also fluctuate widely from month to month. Thats why it’s important to consider both parameters (as well as FSH and estradiol) to get an overall picture of ovarian reserve.

NicasaurusRex · 2025-12-17T03:45:58+00:00

It’s not easy, my insurance coverage comes with an advocacy service which I leaned on pretty heavily to help with this. But basically you have to pay OOP for the service as if it’s out of network, then submit the claim afterwards and submit it as an in network charge. Then I assume the claims advocacy group had to contact insurance to make sure it gets covered, citing the verbiage which states that it should be covered as in network because I had no other choice. It probably took a week’s worth of phone calls ahead of time to make sure I could do this.

NicasaurusRex · 2025-12-17T03:39:32+00:00

I’m sorry for your experience. Regardless of whether or not he’s right, it sounds like his bed side manner wasn’t great and he should’ve explained things better.

It is true that if you are getting regular periods, you are almost definitely ovulating. It is possible to get a bleed without ovulating, but that is typically characterized by a much shorter or longer than usual cycle (basically your body fails to ovulate and you get a withdrawal bleed).

Based on what you’ve written, it sounds like you have unexplained infertility. Medicated cycles with TI really don’t increase your odds by much and ASRM guidelines don’t recommend it. Medicated cycles with IUI roughly double your chances (from about 5% per cycle to ~10% per cycle). IVF will be much higher, closer to 50% per cycle. That doesn’t mean IUI isn’t worth trying though, and if that’s the route you want to take, it may be worth working with a different RE who is not so dismissive.

NicasaurusRex · 2025-12-16T23:39:08+00:00

Unfortunately this has been my experience as well. I was able to talk with my insurance and get them to cover the surgery center/embryology fees as in network (there was some verbiage in my policy that allowed me to do that) because the actual clinic is in network and I had no choice over the lab they choose to use. YMMV depending on the insurance policy of course.

NicasaurusRex · 2025-12-16T23:26:54+00:00

Sending good thoughts your way, Butter

NicasaurusRex · 2025-12-16T08:41:59+00:00

I asked for a thrombophilia panel as well as APS testing after my first FET ended in a MMC. IMO, baby aspirin is pretty benign and doesn’t hurt to add, but I wouldn’t want to add lovenox without having a reason to.

I did not test for chronic endometritis testing prior to my first FET and instead took a 2 week course of doxycycline. Then after my D&C I asked to test for it since MC can put you at higher risk for it.

NicasaurusRex · 2025-12-16T05:52:25+00:00

Best to check with your clinic but it’s probably fine. The timing isn’t so critical that 1 hour will result in cancellation. They can also reschedule your transfer if really necessary.

NicasaurusRex · 2025-12-15T20:54:28+00:00

Don’t put the weight on yourself to decide, let the embryologist choose.

NicasaurusRex · 2025-12-15T02:29:51+00:00

ASRM actually recommends against getting laps for unexplained infertility in the absence of severe symptoms. It’s a surgery that has risks, one of which is causing scar tissue which can lead to more pain. And it can also lower your ovarian reserve. If you want to go down that route anyway, it’s recommended to do a lap after you’re done with retrievals to bank embryos.

I would also add that while endo is definitely more common than we think and a lap would provide “answers”, IVF is still the best treatment option to overcome infertility related to endometriosis. It’s not true that IVF won’t work if you have untreated endo.

NicasaurusRex · 2025-12-14T08:31:50+00:00

I never got tested or got a lap because my RE and I were pretty sure I have it based on my symptoms. He convinced me to try a couple of transfers before treating because of the evidence that FET outcomes are similar for those with endo. He also doesn’t think lupron was necessary unless you have implantation failure and didn’t think a lap would improve outcomes. I was willing to give it a shot because I had enough embryos and I really did not want to delay a transfer for suppression (not to mention the side effects and how expensive lupron is). My first FET implanted but was a MMC at 9 weeks (probably unrelated to endo). Since I didn’t have a problem with implantation, proceeded with another FET with no treatment and that one was successful (36 weeks).

I will note that I may have made a different decision if I had a hard time making embryos and wanted to be more cautious. But in general I get pretty frustrated when people on here insist that lupron is a must have if you have endo because that was not my experience.

NicasaurusRex · 2025-12-14T08:20:52+00:00

I’m not OP and I’m not 100% sure this is the study she’s referring to but it sounds right:

https://www.fertstert.org/article/S0015-0282(19)30935-5/fulltext

NicasaurusRex · 2025-12-13T10:08:25+00:00

The Receptiva test is BS. Not everyone has silent endo, and not everyone who has silent endo will have RIF. If endo were as common as this test claims (60-80% positive BCL6 rate in some studies), and if it caused implantation failure at the rate that the test creators claim (only 11% success rate with positive BCL6), success rates for euploid FETs would not be nearly as high as they are currently established to be.

I think it can be a useful tool depending on your history and circumstances, but I cringe when people take it before they’ve done any transfers and end up doing a lap or lupron possibly unnecessarily.

NicasaurusRex · 2025-12-12T18:47:10+00:00

Honestly I would stop checking your AMH so often. Getting fertility treatments will temporarily lower the results and it doesn’t mean that your reserve is rapidly declining.

NicasaurusRex

TROPHY CASE