Dr’s visit

Yesterday, I met with Dr. Y. for my HSG follow up visit. Highlights:

  • Dr. Y. expressed sincere concern for C.’s accident. (Love him!)
  • Dr. Y. expressed interest in seeing the image of my uterus from HSG that I have on my cell phone. (Even if he was faking, I don’t care. Still love him.)
  • Dr. Y. reassured me that while C.’s pain meds might reduce the odds of a pregnancy, in the event that I do get pregnant, there shouldn’t be any effect on the fetus. (One less thing to worry about.)
  • In the likely event that I don’t get pregnant, I need to call his office as soon as my period starts to schedule an ultrasound. (US has to happen within 3 days of my period start if I want to do IUI this cycle…one more thing to worry about!)
  • The rescheduled date for my menopur class (class to give myself hormone shots for medicated IUI) should hopefully happen before my period starts…if it doesn’t, then I won’t be able to do IUI this cycle. (Another thing to worry about!)
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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!