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paulacaldwell 07-24-2006 10:23 AM

hysterosalpingogram vs lap
I first wanted to say that this messageboard is awesome, all of you are so helpful and supportive, although my family and friends are also very supportive I feel like they must get tired of hearing about my infertiliy issues and thats difficult to me cause this is always on my mind, so thank you all so much!!! I was wondering what the difference is between a hysterosalpingogram and a lap. I had a hyst.. and they found nothing, does that mean that they wouldnt find anything in a lap? I have unexplained infertility, every thing seems to be woking just fine except that were not getting pg. Any info would help. Thanks and good luck to you all!!!!!

suesy 07-24-2006 10:31 AM

Re: hysterosalpingogram vs lap
hi paulacaldwell. :wave: I'm like you - so glad I found this board!! Isn't it wonderful?:D

As far as I know, the HSG test can only determine if your tubes are open, and the pre-test x-ray can sometimes detect cysts (as was the case for me). But it can't detect other potential IF issues, such as endometriosis, which is where the lap comes in. I'm not sure if they check your uterus in a lap, but that's another place there could be polyps, adhesions, scarring, etc. that wouldn't be detected by HSG testing.

hope that's helpful, and hope you find something that can explain your IF & be fixed!! :)

sticky baby dust to you.

cmarie313 07-24-2006 12:56 PM

Re: hysterosalpingogram vs lap
Hi Paula-
I too had an hsg and it come out fine, no blockages or cysts. We also have unexplained infertility. We have been going through it for 2 years. I just had a lap done last Tuesday because I had to have a hernia in my belly button fixed so I decided to let my RE do the lap at the same time while I was under the general. Sure enough, he found an adhesion in my uterus and some endo on my ovaries and uterus!!!! He never thought he would have found anything because I didn't have any endo symptoms??? He feels confident that these two things have been contributing to our infertility and so we will try for the next 2 cycles to conceive naturally(without injections or IUI). So, the biggest piece of advice I could give someone is, to have the lap done. I was so petrified of it that I wouldn't allow him to do it before and I totally regret it!!!!!!!! I could have possibly saved myself lots of heartache, and pain and could have possibly already conceived. So, I would definitely talk to your doctor about it and gather the info, it is better to have all the testing and information you can have done prior to getting into all of the hormones and things like that. Well, that is just my "quarters" worth. Good luck to you!

Marie1971 07-24-2006 01:22 PM

Re: hysterosalpingogram vs lap
My RE told me that there is a 25% false negative and 25% false positive with hystroso... That means that 50% of the findings from this test are actually not accurate! I think! I didn't know that when I had mine done or i probably would have just had a lap. I just had a lap and they gave me a vcr of the surgery. first they looked inside my uterus for adheasions / lesions and any cyst or anything abnormal, then they looked at my ovaries and uterus from the outside (w/a camera put thru a hole in my belly button) also injected some kind of fluid thru my uterus while they were watching the ovaries to make sure the tubes were open. I was put under general anesthia for this and had two incisions (one in my bellybutton and one at bikini line) both incisions were about 1/2 inch or shorter. I can tell you more about this procedure if you want i just had it done jly 7th.
Good luck to you.

Marie1971 07-24-2006 01:24 PM

Re: hysterosalpingogram vs lap
definetly get a lap before you let your doc begin any treatment, I am also unexplained, except for some questionable sperm analysis.
I will be starting my first IuI cycle this month!

suesy 07-24-2006 01:40 PM

Re: hysterosalpingogram vs lap
I hadn't heard those stats (or any stats, for that matter!) regarding the accuracy of the hsg test (wow - doesn't sound promising! :eek: ) - I always thought of the hsg as one of the first things they do when you can't get pg naturally. If the tubes look open, they'll go on to other tests. They never did the hsg test with me b/c they found the cyst and went right to surgical lap. They checked my tubes while they were in there. Either way, I think cmarie & marie are right - the lap will certainly give you additional info and it's worth a shot. I think cmarie & I had longer recoveries from our laps b/c they were surgical. From my understanding, a diagnostic lap wouldn't be as involved or long of a procedure, and therefore wouldn't require as long of a recovery time. maybe? :confused: :D

cmarie313 07-24-2006 01:50 PM

Re: hysterosalpingogram vs lap
I have never heard that before about the HSG being 50% accurate? How could it, if the radiologist is looking at the dye going through the tubes and ovaries? I don't know how it could show that the tubes are open, if they in fact were not? That just doesn't sound right to me? As far as the lap, they are all "surgical" and mine started out as an "investigation" in that my doctor didn't think that he would find too much. It ended up that there was some mild endo and the adhesion so he removed it then, which obviously causes more discomfort in the recovery process. The major source of my pain was through my belly button and the surrounding muscles where the scope goes through(not fun!). I hope this info is helpful, if we can answer any more questions from our experience, just let us know;)

paulacaldwell 07-24-2006 03:16 PM

Re: hysterosalpingogram vs lap
Oh wow,judging by all of your replies I probably should have had a lap done already. Maybe I need to find an RE,can anyone give me some tips on finding one, I live in the Ventura county area. Are RE's more expensive than gynos? By the way thanks again, I swear I get way more info from you all because youve gone through all of this, than I do from any drs

Marie1971 07-24-2006 03:48 PM

Re: hysterosalpingogram vs lap
Me Again, Don't Take My Word For It, Do Your Own Research, I Could Have Heard The Doc Wrong!! My Obgyn Also Mentioned To Me That There Was A Chance It Could Be Inaccurate But Never Mentioned The Percentage. Sorry If I Posted Inaccurate Info!!! In Any Case I Would Still Be More Comfortable With A Lap Before Going Forward With Any Type Of Infertility Treatment.

Marie1971 07-24-2006 03:54 PM

Re: hysterosalpingogram vs lap
I Read Somewhere That You Should Choose A Clinic Based On Their Success Rates, But Educate Yourself! The Center For Disease Control Keeps Track Of Clinic Success Rates I Think If You Google "infertility Clinic Success Rates" You Should Find What You Are Looking For.

Raleigh girl 07-24-2006 03:56 PM

Re: hysterosalpingogram vs lap
I had a HSG come back normal. Later my doctor discovered what appeared to be a uterine polyp the size of an a m & m. I was a little peeved b/c the HSG was around $900 and for what? Anyway, I had a D and C, so we'll see.

I guess what I'm saying is don't put too much faith in the HSG test. It sounds like it isn't very accurate.

Good luck to you! :)

suesy 07-24-2006 04:20 PM

Re: hysterosalpingogram vs lap
yes, checking the CDC website is a great start - they list all clinics by state, and there are a ton in socal (I'm in redondo beach! :wave: ), tho' I'm not sure how many are in ventura county... I searched mainly in LA county. But if you have insurance that will cover any or all of IF treatment, you may also want to check with your insurance company to see if they have an approved list of clinics, and to see if you need a referral from your ob/gyn to get it covered.

In addition to success rates, you should check their prices and payment options if your insurance doesn't cover everything. Some clinics are much more expensive than others for the same procedures... but then again, their success rates might be higher, so you'll probably want to weigh some of these factors in making your decision.

Best wishes finding a good RE!! :D

paulacaldwell 07-24-2006 04:33 PM

Re: hysterosalpingogram vs lap
I didnt know that there was insurance that covers IF, I think Id like to find that first, any info on that would be very helpful.

suesy 07-24-2006 04:44 PM

Re: hysterosalpingogram vs lap
unfortunately, CA is one of the states where insurance companies aren't required to offer IF coverage (as opposed to states like MA, where most insurance companies have to offer that coverage). My insurance (Blue Shield HMO) covers 50% of IUI, including meds to go along with it, but doesn't cover IVF. That's why we tried IUI so many times before moving on. A colleague of mine had 100% of her IVF covered (through her husband's insurance - he works for a pharmaceutical company), so I guess it will vary tremendously depending on your insurance company.

You probably can start by going online to your insurance company's website and see if you can access a list of your benefits... usually there's a separate listing under the "infertility" category that will indicate what, if anything, is covered.

hope that helps! :)

cmarie313 07-24-2006 06:04 PM

Re: hysterosalpingogram vs lap
I am a teacher in Illinois and my insurance covers infertility 100%, including medications and 4 tries at IVF! I am so fortunate because as we all know, IF is very expensive. I wish you the best of luck!

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