After discovering that I have a unicornuate uterus, my OB/GYN sent us off to a Reproductive Endocrinologist.
Before we made an appointment with an RE I did a ton of research to see which fertility clinics in the greater Denver Metro area had the best stats, and if you ever have to go to an RE, I highly recommend you do your research too. Your doctor won’t always recommend the place that has the best IVF success or live birth rates; a lot of their recommendation is based on who they tend to work with most or who they know is close by, neither of which are necessarily top criteria for your choice.
Cost is a huge consideration too. A lot of fertility clinics now offer an IVF refund, which will essentially refund you for all procedure related costs if you fail to have a live birth after three rounds of IVF. This is a HUGE help as insurance rarely covers infertility treatments unless you reside in one of a handful of states in the U.S. that require fertility treatments to be covered. I could rant all day about the fact that I’ve never used health insurance benefits in my entire life outside of my routine annual physical, and go figure, the one “ailment” that I have isn’t covered by insurance. We have a seriously messed up healthcare system. I digress. On the bright side, my insurance does cover infertility diagnostics, which means that all consultations and tests ordered to determine the cause of infertility are covered (well, if you count 80% of treatment costs + a $40 copay per visit as ‘covered’).
Being in a biggish city, we had our choice of several locations, all with varying costs and success rates. We chose a fertility clinic that had several locations throughout the area, and were fortunate that the director of this particular practice had availability ten days out from when we called.
Before our initial consultation, Kev and I had to dig up all of our immunization and medical records and submit detailed family histories. When we arrived our doctor sat us down for a brief consult. It was clear that he’d already reviewed our histories, as he had a short list of tests he wanted to run that day. He spoke largely in medical terms that I was proud to say I recognized, mostly from incessantly reading medical journal articles on the NIH website the week preceding our consult. Later Kevin told me he only understood what was being said because I’d talked about so many of those terms prior to our visit – proof that my detective-style research methods have merit. (#winning)
The first test on the agenda was a repeat of the transvaginal ultrasound (I’d had one done at my regular OB/GYN’s office a couple of weeks prior). Our fertility doctor was skeptical that an ultrasound tech could have diagnosed a unicornuate uterus and said that typically an MRI and/or HSG is needed to do so. He and his technician proceeded to prod around and could only definitively tell me that my uterus deviated pretty hard to the left. He thought that the top of my uterus looked normal, so determined that an HSG was the next appropriate diagnostic step. An HSG is an x-ray procedure where an iodine-based dye is injected into the uterus to 1) see its shape and 2) to determine if my fallopian tubes are open. If the tubes are open, the dye spills out of the ends of the tubes.) I was told I would have to schedule that procedure for a date between cycle days 6-12 of my following cycle (post-menstruation & pre-ovulatory phase of the cycle). More tests, more time. Okay. Sigh.
At the time of this ultrasound I was on cycle day 22, so they did a follicle count and found 6 on the right & 5 on the right. Apparently any number above 10 is considered normal, and follicles are harder to count in the luteal (post-ovulatory) phase of the cycle, so being able to count 11 on cd22 was good.
After they were done looking at my uterus, we did an ultrasound to see if I had both kidneys. Since it’s quite common for women with a unicornuate uterus to only have one kidney, I was super interested to see the results. They turned me to my left side (the side that we had every reason to believe was the fully functioning side) – yep, there’s your left kidney. They turned me to my right side – aaaaand, yep, there’s your right kidney. No way! I’d lived for like ten days of my life thinking I only had one. Bonus, I have two. Awesome.
After being told that my uterus looked normal from the top and that I had two kidneys, I pretty much convinced myself that I didn’t have a unicornuate uterus and that it must just deviate to the left. No big deal. But the tests weren’t over yet.
Next, I was told to put my pants back on and go get blood drawn for progesterone, estradiol, and AMH levels. Okey dokey. Keep in mind my poor hubby was with me through all of this. He is such a nice man. A chipper and efficient nurse drew two vials of blood and sent us on our merry way. We’d have results in a few business days.
From there, we scheduled my HSG for cycle day eight of my next cycle and I was sent home to count down two more weeks until my next appointment.