The try

First, an update: After 7 days in the hospital, C.’s risk of further internal bleeding was considered low enough to let him go home. The final tally (after hearing from a team of trauma surgeons, radiologists, and the like) was a bit worse than I said in my last post: 7 broken ribs, 3 broken vertebrae, class 4 lacerations on both liver and spleen, and a hemopneumothorax (blood and air in the chest cavity). Incredibly, he did not require surgery – just a few stitches on his knee, close monitoring for internal bleeding, and a $*#!load of painkillers (more on those later). Since he was in San Jose at the time of the accident, the ‘home’ that they released C. to is his parents’ house. Yesterday, I flew back to San Diego to return to work. The plan is for me to fly to San Jose again on Friday to pick up C. and bring him ‘home’ to San Diego…

But this blog is supposed to be about infertility. As I mentioned before, the timing of C.’s accident relative to my anticipated ovulation date made it unlikely that we would get to try this month. Well…I’ll spare you the details, but suffice it to say that there is at least the possibility (however remote) that I could get pregnant…(Nobody can accuse C. of not being dedicated to baby-making!)

Now whether that would be a good thing is another question entirely. In the past week, C. has been on a laundry-list of painkillers, most opiate narcotics. In the hospital, his drug of choice was hydromorphone (trade name Dilaudid), a fast-acting IV narcotic. Unfortunately, he couldn’t take that one home and had to settle for the ones that come in pill form, including time-release oxycodone (trade name OxyContin); a mixture of hydrocodone and paracetamol (trade name Norco); and ibuprofen (trade name Motrin). The narcotics are all derived from the natural products morphine and codeine, alkaloids produced by the opium poppy. For your viewing pleasure, I’ve pasted the chemical structures below.

If we do get pregnant this month, our baby might come out addicted to prescription painkillers!

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HSG

The HSG took about 5 minutes (excluding time for me to strip from the waist down) and was virtually painless. (I had a few cramps on the drive afterward, but less even than a bad menstrual cramp – not that I ever get bad menstrual cramps…) To the utter bewilderment of my radiologist, I asked to take a photo of the screen. For your viewing pleasure, here’s my uterus and Fallopian tubes:

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I think the fact that you can see the white hair-like projections (my Fallopian tubes) coming out of the white triangle in the middle (my uterus) shows that everything is flowing freely. So plumbing doesn’t appear to be the problem (which we pretty much already knew). Now all I have left for my IUI homework is my injections class next week. Should be fun!

For today’s chemistry lesson, I tried to figure out the likely structure of the dye that they put in my uterus to appear all pretty and white on the x-ray above. I didn’t actually check what they used, but from what I can tell the vast majority of these dyes are small, iodinated organic molecules like the ones shown below. The iodine atoms are the most important part, and are what makes it show up white on the x-ray. There are two classes of iodinated contrast media: ionic (which contain a carboxylic acid group – shown in blue below – somewhere in their structure), and non-ionic (that don’t have a carboxylic acid). For imaging the digestive tract, they often use an inorganic compound – barium sulfate – but I’m going to assume that’s not what they used for my HSG.

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My IUI ‘homework’

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Today, I had my blood drawn for a blood pregnancy test, and picked up my prescription for doxycyline. This is in preparation for my hysterosalpingogram (HSG), which happens tomorrow morning, all part of the ‘homework’ my doctor gave me to do before we can move on with medicated IUI.

The HSG involves injecting a dye into my cervix and taking x-rays of my plumbing to see whether I have any blockages or uterine abnormalities not visible by ultrasound. This whole process would not do good things for a fetus, which is why I had to take the blood pregnancy test today. There is also a slight risk of infection, hence, the doxycycline.

Since this blog is titled ‘The Infertile Chemist’, I figured it should have some chemistry in it… Doxycycline is a broad-spectrum antibiotic (so I should be protected against a wide variety of pesky bacterial pathogens!), designed by chemists at Pfizer in the ’60s. More interesting (to me, anyway) is that it was inspired by the tetracycline family of natural products, including the first tetracycline to be discovered – chlortetracycline (aka aureomycin). Chlortetracycline is produced by a soil bacterium called Streptomyces aureofaciens. (Streptomycetes like S. aureofaciens make tons of cool antibiotics and other natural products.) Chlortetracycline is a polyketide, which means the bacterium makes it by connecting together two-carbon units in an assembly line fashion.

Anyway, I’ll start taking doxycycline tonight, and go in for my HSG tomorrow… I’ve read that it can hurt, particularly if one has blockages, so I’m hopeful that everything flows through without too much resistance. On the plus side, I’ve also heard that women who’ve just had their plumbing flushed by HSG have slightly higher pregnancy rates that month, so here’s hoping!