A letter to My Period

Dear Period,

Who are you? I have heard many men spoke about us women as complicated as they asked who we are. I am led to believe that you play a major role in this and yet, here I am, a woman, asking who are you?

This month you showed up on time, but you visited me with your cramps some two weeks before.  Then you came with your headaches and belly aches and your insomnia. Why wouldn’t you allow me to sleep? What have I done to you?

I have been trying to figure you out for years. I have been very lucky, I supposed, to always know what time you would come.  I have heard several of my friends complaint about your lack of manners just showing up when and where you feel like and when you do, you appear to want to make up for the time you did not come, lasting weeks and sometimes months, and then you would leave and stay away for months again. You remind me of some baby fathers who appear with their two big scandal bag of groceries after months of not seeing them, somewhat believing that they are doing the world of good and can make up for the time of their absence. We hate men like those!

I am glad you have not done that to me because I would be pissed! I am super organized and you just would not have fitted in. Yet, you still trouble me; the mysteries that surround you are overwhelming. Month after month, I see a new face. Sometimes, you visit and have me snapping at everyone, husband, parents, siblings, child and even the dog for just looking at me.

Then another month, I am an emotional wreck. It is all about the tears I do not understand. I am not normally a 'bawler' Misses Period, but you! I am afraid to go to the movies or even out in public because all it might take is for a dog to pee on the sidewalk to make me cry and ask, why can’t men tie their dogs and keep them at home? Why do they let them roam and destroy our beautiful surrounding?

Do I have any good memories of you? I think in the absence of you, when I got pregnant with my daughter. Oh what a joy and relief. I needed that time off to see where our relationship stood. I wondered throughout the pregnancy if I should end the relationship completely. I wanted more than a separation. I wanted a divorce, but alas, here we are together again. You won because I was thinking then about another child. Sigh!

I guess I should be grateful. I hear you whisper every month, if I remember. Yes I remembered how you use to have me as teenage and young adult curled up on the bed before moving to the floor. I was your slave then and you enjoyed it. I tried pain killers upon pain killers and you pretended as if they worked before you spat in my face. You had me twisting and turning like a ship on a stormy day and there were other times I felt like an acrobat in the Olympic Games. You would bend me in some super positions that I thought were beyond me and then give me a break from your pain and in fear of you, I would stay in that position until I could not anymore. You were such a monster! So yes I remember. That’s why it was so easy for me to do that surgery. When everyone else was in fear, I was smiling. I broke your arms and legs. I should have ended you!

What is Pelvic Congestion?

I think the hardest part of being a woman with some struggle (fibroids, PCOS, PMS, Endometriosis etc)  is trying to understand all the things you are going through. Even after you have done surgery to  aid, some times you still struggle and there are times new issues to deal with.

My PMS tends to be different each month. One month it may be serious headaches, others mood swings, but the main problem that I had is lower back pain. This tend to occur monthly and some months worse than others. It starts somewhere deep in my left pelvic, around the hip and into the lower back. I often find it difficult to describe it to the doctor. While there are times it feels like serious pain, most times it is a dull ache and the only thing that seems to sooth it is deep tissue massage which I just want someone to do until I fall asleep.

I have seen many different doctors with my back pain and did several x-rays where nothing abnormal was revealed. I also went through Physiotherapy, but stopped after I was not showing any improvements and they felt that it was a gynecological issue. So I went back to my Gynae and he said, it is pelvic congestion. What is Pelvic Congestion? Here is what I found out:

Pelvic Pain (Pelvic Congestion Syndrome)Ovarian Vein and Pelvic Varices

What is it?

It is estimated that a third of all women will experience chronic pelvic pain during their lifetime.  Chronic pelvic pain is defined as “non-cyclic” pain lasting greater than six months. A multidisciplinary team approach is needed to treat this often complex medical condition. After a physical examination, a Pap test to rule out cervical cancer, and routine laboratory bloodwork, a cross-sectional imaging study is obtained to be certain that there is not a pelvic tumor. If the clinical symptoms are those of chronic pelvic pain, worse when sitting or standing, and sometimes also associated with varicose veins in the thigh, buttock regions, or vaginal area, the possibility of ovarian vein and pelvic varices must be considered.

Source: http://www.hopkinsmedicine.org/interventional-radiology/conditions/pelvic/

Prevalence

• Women with pelvic congestion syndrome are typically less than 45 years old and in their child-bearing years.
• Ovarian veins increase in size related to previous pregnancies. Pelvic congestion syndrome is unusual in women who have not been pregnant.
• Chronic pelvic pain accounts for 15 percent of outpatient gynecologic visits.
• Studies show 30 percent of patients with chronic pelvic pain have pelvic congestion syndrome (PCS) as a sole cause of their pain and an additional 15 percent have PCS along with another pelvic pathology.

Risk Factors

• Two or more pregnancies and hormonal increases
• Fullness of leg veins
• Polycystic ovaries
• Hormonal dysfunction

Symptoms

The chronic pain that is associated with this disease is usually dull and aching. The pain is usually felt in the lower abdomen and lower back. The pain often increases during the following times:

• Following intercourse
• Menstrual periods
• When tired or when standing (worse at end of day)
• Pregnancy

Other symptoms include:

• Irritable bladder
• Abnormal menstrual bleeding
• Vaginal discharge
• Varicose veins on vulva, buttocks or thigh.

Diagnosis and Assessment

Once other abnormalities or inflammation has been ruled out by a thorough pelvic exam, pelvic congestion syndrome can be diagnosed through several minimally invasive methods. An interventional radiologist, a doctor specially trained in performing minimally invasive treatments using imaging for guidance, will use the following imaging techniques to confirm pelvic varicose veins that could be causing chronic pain.

Pelvic venography: Thought to be the most accurate method for diagnosis, a venogram is performed by injecting contract dye in the veins of the pelvic organs to make them visible during an X-ray. To help accuracy of diagnosis, interventional radiologists examine patients on an incline, because the veins decrease in size when a woman is lying flat.

MRI: May be the best non-invasive way of diagnosing pelvic congestion syndrome. The exam needs to be done in a way that is specifically adapted for looking at the pelvic blood vessels. A standard MRI may not show the abnormality.

Pelvic ultrasound: Usually not very helpful in diagnosing pelvic congestion syndrome unless done is an very specific manner with the patient standing while the study is being done. Ultrasound may be used to exclude other problems that might be causing pelvic pain.

Transvaginal ultrasound: This technique is used to see better inside the pelvic cavity. As with a pelvic ultrasound it is not very good at visualizing the pelvic veins unless the woman is standing. However it may be used to exclude other problems.

Treatment Options

Once a diagnosis is made, if the patient is symptomatic, an embolization should be done. Embolization is a minimally invasive procedure performed by interventional radiologists using imaging for guidance. During the outpatient procedure, the interventional radiologist inserts a thin catheter, about the size of a strand of spaghetti, into the femoral vein in the groin and guides it to the affected vein using X-ray guidance. To seal the faulty, enlarged vein and relieve painful pressure, an interventional radiologist inserts tiny coils often with a sclerosing agent (the same type of material used to treat varicose veins) to close the vein. After treatment, patients can return to normal activities immediately.

Additional treatments are available depending on the severity of the woman's symptoms. Analgesics may be prescribed to reduce the pain. Hormones such birth control pills decrease a woman's hormone level causing menstruation to stop may be helpful in controlling her symptoms. Surgical options include a hysterectomy with removal of ovaries, and tying off or removing the veins.

Source: http://www.sirweb.org/patients/chronic-pelvic-pain/

The Horror of Mood Swings

Source: http://www.jonesfamilychiropractic.com/wp-content/uploads/2014/10/mood-swings2.jpg

Of lately, I have been going through some terrible mood swings. It is not that I have never gone through this. In fact, prior to having my baby and while suffering from endometriosis (unknowingly) and fibroids, my periods were very terrible and mood swings were a big part of the package so much so that it appears as normal for at least that part of the month. However, after having a baby and having been placed on birth control pills (Lindynette 20), I was at a place of peace. I wasn't really sure what had help because there are so many stories out there. There are some persons who claim that if you were having terrible period pain, it will go away once you have a baby. The solution to period pain...Have a baby! However, I met others who said that it was not true and since there are really no scientific evidence, I assumed that the no mood swings, little to no period pain, no breast tenderness, no mid-cycle pain had more so to do with the birth control pills rather than just having the baby. Also, partly so because in an attempt to avoid a period one month, I doubled up on the pills, but did not bother to finish the other pack since the occasion that I was doubling up for had passed. Instead, I waited for my period to came, following which I resumed the pill. It seemed as if my hormones went haywire.

Since then, apart from the other effects, I have been experiencing these terrible mood swings and I so decided to do a little blogging.

How is related to the Uterus
While there are may causes of mood swings, including stress and anxiety, drugs and alcohol, depression and bipolar disorder, premenstrual syndrome (PMS), menopause and premenopause are also notable causes. The latter are related to hormonal changes including low estrogen levels, which in many ways are link to issues relating to the uterus.

What are the Symptoms
When does it happen is a question that I can never really answer. You may be going quite well, the previous day or even wake up in a good mood and the next thing you know, your mood just change. Sometimes, you can identify a trigger, for example, something was said or something occured, but most of the times, for me, I am not sure when it happened. Worse, it can occur for a few days. One minute, you are laughing and the next, you are quiet and easily upset. Now imagine if you are married and/or have kids...

What are the impacts?
I think the worse impact for me is trying to maintain my 'sanity' in the midst of my marriage. You may find yourself snapping at your kids or spouse for silly things and as such may negatively affect your relations with your family.

You may become very emotional for absolutely no reason. There are times my mood swings are so terrible that everything just gets to me and arouses my anger. Not simply just one element, but everything. So for example, the house that I just finished cleaning was messed up by my daughter in just a few seconds, but it is not only that, but everything else is racing through your thoughts...the need for vacation, the dishes in the sink, the clothes to fold, the food to cook. Your spouse may try to help by doing some cleaning and folding, but it is not helping. Somehow you prefer him to leave the home with your child/children and just give you the house to yourself. Seeing people may upset you, the bark of a dog may upset you, the loud noises of the neighbour may upset and you know something is wrong because all of these things, on a regular day, will never upset you. Yes, it is indeed the horror of mood swings!

How do you manage it?

I have never sought medical help and if anyone has,I hope you will share your experiences by commenting on this blog, but there are certain little mechanisms I live by.

• I talk less during this period. To talk less prevents me from saying things I will later regret.
• I take space, which at times include a bedroom or bathroom escape. Yes, I will go in there and try to relax. Sometimes I shed a tears for the emotions I cannot understand.
• I find that I also feels better after exercise and I believe that may help if the mood swing is trigger by stress

How do you manage your mood swings?

Can Ovarian cysts cause infertility?

It is a terrible pain to want a child and to have difficulties. I think what is worse is when you have so many questions and so little answers. For example, Why am I not getting pregnant? When a doctor tells you this is normal, that is normal and cannot pinpoint exactly why you are not getting pregnant or why you are miscarrying. It is a large pill to swallow. 

Recently, I have been diving into greater research as I speak to persons and listen to their cries. Today, I want to share something on ovarian cysts and whether it can lead to infertility. You see, if we can pinpoint the cause then we can better manage it.

There are several different types of ovarian cysts and from my research, these are the two that are associated with infertility:

1. Endometriomas- are cysts caused by endometriosis, a condition in which the tissue normally lining your uterus (endometrium) grows outside the uterus. These ovarian cysts may be associated with fertility problems. 

Now I have gone through this type, but prior to knowing that I had endometriosis, the doctors were telling me the cysts I had was probably a functional cyst, which is another type not associated with infertility, and it will go away with my period. To be honest, at the end of my period, I will feel less pain and thought that they were right. However, there were times that the pain remains and when I do the ultrasound, I was told that it is hemorrhagic or has ruptured. The treatment was a sit, wait and watch. It was only during my surgery to remove fibroid that endometriosis and the associated cysts were identified. However, many persons are living with endometriosis and do not know because it is not easily identified.To identify endometriosis, a doctor may ask about your medical history, symptoms and menstruation and also do a pelvic exam. I have done numerous and they never found out. What helps to diagnose and even treat endometriosis is a surgical procedure called laparoscopy, which is a surgery that uses a thin, lighted tube put through a cut (incision) in the belly to look at the abdominal organs and pelvic organs. Sadly, many gynaes fail to mention this to you even when you suggest to them the possibility of you having endometriosis. I do not know how much such procedure costs, but I believe in researching and going to your doctor with information. If you have been suffering with ovarian cysts, you have painful (terrible) periods, infertility etc etc, ask a doctor about whether you may have endometriosis and what tests you can do to identify this especially if you have gone through numerous ultrasounds and pelvic exams without any good answers.

2. The second type of cysts that is associated with infertility is Ovarian cysts resulting from polycystic ovary syndrome.Polycystic ovary syndrome (PCOS) is a condition marked by many small cysts on your ovaries, irregular periods and high levels of certain hormones. PCOS is associated with irregular ovulation, which may contribute to problems such as infertility in some women.

Now I cannot give you my own personal experience with this type, but I know of persons who have it and here are some of the symptoms:

• Few or no menstrual period or heavy irregular bleeding- I know of persons who have not had a period for years because of this or they are not aware when it is coming. In other words, it occurs haphazardly and when it does come, it as if it wants to make up for the missing months by coming for weeks, which is outside the normal 5 days. It also tends to be heavy. Another symptom of PCOS which is very much related to this one, is infertility. A big part of getting pregnant is identifying when you are ovulating and I do not need to explain the issue here with a period that just show up when it feels like or refuse to show up at all. 
• Weight gain- This is another major complaint. You do not have to eat a thing for the weight to come and when it does, it does not want to leave. In other words, you may be dieting and exercising and the weight is still there staring you in your face and this may also lead to depression. Still, you need to watch what you eat and also exercise.
• Hair loss and Hair growth- While I have not met many persons with a hair loss problem who have PCOS, I have heard about hair growing thick and long in places other than your head. This again can lead to depression.

There are other symptoms such as acne, breathing problems and oily skin, but the above ones I have mentioned is based on report from a few friends I have spoken to.

Sadly for many of these illnesses, there is no cure. With PCOS, the treatment include having a healthy diet, exercising regularly and quit smoking. Medications include metformin and clomiphene. These are efforts to manage PCOS so that your body can ovulate which can help you to get pregnant. The silver lining is there are people with PCOS that have gotten pregnant and so there is hope. Just the same, persons after treating endometriosis have also gotten pregnant. I am an example of that and so with that I end by saying, Continue to do your research, do not lose hope and trust in God even when everything that you are doing seems to be a waste of time. 

Endometriosis: Myths or Facts

I recently found this article online and wanted to share with you because it provided some answers to the many questions I have after I found out about my endometriosis and subsequently had a surgery that removed, hopefully all of it. Here is the article as it written on the Women's Surgery Group, http://www.womenssurgerygroup.com/conditions/Endometriosis/overview.asp:


ENDOMETRIOSIS: OVERVIEW

Endometriosis is an enigmatic disease affecting about 7% of reproductive-aged women -approximately 5 million Americans. Although they may suffer significant symptoms ranging from pelvic pain to infertility, most of these women do not know that they have endometriosis,. Physicians' understanding of (1) the clinical presentation of endometriosis, (2) its proper diagnosis and staging, and (3) the management of its sequele have improved dramatically over the past few years. The result has been better, more cost-effective patient care.

Definition

Endometriosis is the presence of endometrial tissue (normally found only on the inside of the uterus) in locations outside the uterus. This tissue reacts to estrogen and progesterone. The usual location is in the pelvis (on the ovaries, fallopian tubes, uterus, or bladder), but endometriosis has also been found in sites outside the pelvis (including omentum, small intestine, appendix, anterior abdominal wall, surgical scars, diaphragm, lung, urinary tract, and musculoskeletal and neural systems). This endometrial tissue reacts to hormonal changes during the menstrual cycle, just as endometrial tissue lining the inside of the uterus reacts during the normal ovulatory cycle.

Prevalence and Incidence

The prevalence and incidence of endometriosis depends on the population of women being studied, ranging from 1 to 50%. It has been reported to occur in 10 - 15% of women undergoing diagnostic laparoscopy, 2 - 5% of women undergoing tubal sterilization, 30 -40% of infertile women having laparoscopy, and 14 - 53% of women with pelvic pain.

Pathophysiology

There are several theories that attempt to explain how endometriosis develops. The most popular theory describes retrograde menstruation through the fallopian tubes, with subsequent implantation and growth of endometrial cells contained in the menstrual blood. Other theories involve metaplasia (normal tissue in the abdominal cavity spontaneously changing to endometriosis), direct implantation of endometrial cells into the abdomen during surgery, and spread of endometrial cells from the inside of the uterus to other locations via blood vessels or lymphatics. Each of these may contribute to endometriosis in different patients. Altered immunity may also play a role.

Numerous factors seem to affect whether a woman will have this condition, the severity of the disease in any particular woman, her symptoms, and her response to treatment. These include:

• genetics (an affected sister or mother doubles the risk)
• hormonal status (higher estrogen levels and prolonged heavy menses increases risk)
• lifestyle (low body weight and cigarette smoking reduce risk by decreasing estrogen levels)
• contraceptive use (oral contraceptives possibly reduces progression of disease)
• obstetric history (pregnancy and lactation reduce risk)
• anatomic factors (cervical stenosis increases risk)
• treatment history (prior medical or surgical treatment reduces risk)
• race (caucasions are at higher risk than african-americans)
• and possibly exposure to environmental toxins, especially those which are estrogenic

Endometriosis is thought to cause infertility by distorting anatomy, creating hormonal abnormalities, altering the pelvic biochemical enviornment, influencing the immune system, interfering with sperm function, and (possibly) altering the process of embryo implantation.

Clinical Presentation

Endometriosis primarily presents with pelvic pain (about 80% of patients). About 20% of patients presenting with endometriosis are also infertile, and 5% present with a "tumor" of endometriosis in one or both ovaries (these are called endometriomas). Anywhere from 1 to 40% of patients with endometriosis will have no symptoms. Endometriosis may occur anytime after puberty, including adolescence.

The extent of a patient's pain often does not correlate with severity of her endometriosis. Pain may occur as a result any or all of the following:

• endometrial implants secreting irritating factors (e.g., histamine)
• scar tissue (adhesions)
• leaking endometriomas
• compression of other abdominal structures (e.g., bowel, ureter)
• compression of endometriotic nodules deep in the pelvis
• invasion of the urinary tract (bladder or ureters)
• invasion of the gastrointestinal tract (small bowel or colon)

Even in patients with minimal and mild disease (AFS stage I or II), endometriosis is probably associated with infertility. A cause-effect relationship most certainly exists for moderate and severe disease (AFS stage III or IV). These patients usually have adhesions, deep invasive lesions, and endometriomas. Endometriosis may also be associated with structural abnormalies and damage to the fallopian tubes. Studies overall do not, however, support an association between endometriosis and increased spontaneous abortion rates.

Endometriosis lesions occur throughout the pelvis. They tend to be more frequently in the posterior cul-de-sac and the ovary, and less frequently on the fallopian tubes. Endometriosis is almost certainly a progressive disease, but the rate of progression and nature of lesions varies from patient to patient.

Adhesions develop as a result of the inflammatory process caused by long standing endometriosis, with more extensive and dense adhesions developing over time. The worst adhesions in the most advanced cases usually involve the uterus, ovaries, and lower colon (near the rectum). Laparoscopic surgical treatment of these cases is always preferable, but demands skill, extensive experience, and patience on the part of the operating surgeon.

Pregnant with Fibroids, Pregnant after myomectomy!!

It has been a while that I have posted as I have been busy writing up my PhD dissertation, but I tried during that time to post on the issues of the uterus facebook page. The two messages that I am going to share with you in this blog was sent to me via my page a few days ago. Amazing news and it shows that if you continue to trust God, things will work out. I hold fast to the scripture that says faith without works is dead. So I encourage you to eat right, seek your doctor' advice and pray without ceasing in your quest for kids. Here are the ladies messages:

Message 1: 

Hey Rose-Ann,

Last time we spoke was in May. In June I found out I was pregnant and was due Feb7 15. In the early weeks of pregnancy I had to go to the er as I started to bleed. They called it a threatened miscarriage. Thankfully I was discharge after a few tests were done. My pregnancy was going well until last Tuesday morning at 2am my water broke. My hubby rushed me to L&b and the nurses along with my doctors worked vigorously to try and get me to 34weeks of pregnancy. My pregnancy of course was high risk due to fibroids and everyone commented that I was blessed to even get this far along. 

Well my little fella had other plans and decided to make his entrance at 31weeks on 6Dec @916am. He weighed 3lbs13ozs. He is a miracle baby I must say and all praise and thanks to God.

He has been breathing on his own and has being doing well thus far. No oxygen has been used thus far and I truly thank God.

He has to spend some time in the Nicu. I just wanted to let you know and thank you for your prayers and please continue to prayer for my Ethan that he would keep progressing.

God is indeed the greatest of physican.

Message 2:

I've been following this post for some time now and just wanted to share my story in the hopes that it helps: 

I found out earlier this year that I had two large fibroids. At the advice of my Dr. I had an open abdominal myomectomy ( surgery to remove uterine fibroids) in March of this year 2014. My doctor told us to wait six months before getting pregnant so we started trying to get pregnant after four months and we were successful on my second cycle (August 2014) which made it five months post myomectomy. 

I am now 16 weeks pregnant and I am happy that we made the decision to have the surgery done. I believe that it was because of this surgery and the Grace of God that we were able to conceive so quick. 

Although this is my third pregnancy there is a 18 year gap with me having one son that is 18 and one that is 20 years old; so this is kind of a new pregnancy and I have forgotten a lot about what those pregnancies were like. 

To answer some questions about how this pregnancy has been thus far... there was a lot of cramping initially in the first trimester as well as irritation and pain around the incision site which my doctor said was normal. 

I have had three ultrasounds so far and one revealing one tiny fibroid that my doctor said probably came after surgery and one ovarian cyst that comes and goes that they're not overly concerned about. I will go to a perinatal Dr. which is for high-risk pregnancies to have an assessment towards the end of this month to find out if I will actually be considered high risk or not and I will find out when they will schedule my C-Section. I have a tentative due date in May because after a myomectomy it is necessary to have a cesarean due to uterine rupture. I struggled with having to have a cesarean after having two very easy vaginal births but it is definitely worth the sacrifice to receive such a blessing! So I will find out a more definitive due date from the perinatologist doctor. I am 37 years old so I have to have all of the standard genetic testing which has been good news so far. I just wanted to share my story to let people know that there is life and hope after a myomectomy. I am very spiritual and I prayed to God for total healing after my surgery and he answered our prayers. Blessings, Healing and Baby Dust to you all!!!

Why can't I get pregnant?

I found this very interesting video describing some of the reasons behind fertility that I wish to share with you. Often times we are confuse about infertility or may think it is one thing when it is another. This video gives a detailed description of the reasons surrounding infertility. Please leave a comment if you find it helpful.

Your Fertility and you

It could be something different than you think:

So I have a thought today as I continue thinking about ways in which women can improve their fertility and manage the different issues of the uterus. What came to mind is Misdiagnose. For example, you may found out that you have fibroid after trying to get pregnant with no luck. Sometimes doctors fail to check you for other issues, when they found out you have one, but if you remembered my blog, you would realized that all the time I thought that fibroid was the reason for my infertility. I had done other tests, for instance, to check if my tubes were blocked and those were ok. It was only after my surgery to remove the fibroids, I found out that I also had endometriosis. I say that to say, that it might be good to get a wholistic health check, especially if you have already taken drastic measures such as surgery and are still faced with fertility issues. In the meantime, as hard this might be, try to maintain healthy weight by eating right and exercise and reduce stress levels. My prayers are still with all of you that God will bless you with the heritage of your womb. I found out something about a natural product recently, that a lady who has endometriosis and was unable to conceive, stated that at 39 years of age, she is pregnant with her first child, which she attributed to these products. I am still researching so I would say more in a later post, but what I can say now is that it helps balance hormones, which is a factor affecting many of us who are faced with issues of the uterus. If you want to hear more, you can inbox me, but I will say more in a later post.

Source: Author

When is it time to consult a fertility specialist?

Getting pregnant may not always happen as quickly as couples would like. Especially when pregnancy fails to result after months of trying to conceive, couples may want to consult an infertility doctor who can determine if either partner has a condition hindering conception. For couples that are already aware of an existing problem such as endometriosis or prior miscarriages, infertility doctors recommend seeing an expert when more than six months pass without getting pregnant. Even in the absence of a health condition, couples where the female partner is 35 years old or older should also consult a specialist after six months of unsuccessful conception. Couples in good health and of younger age can wait an additional six months before reaching out to an infertility doctor should they experience difficulties conceiving a child.

Source :http://www.chicagoinfertilitydoctor.com/835160/2014/06/13/when-is-it-time-to-consult-a-fertility-expert.html

Abortion and Infertility

I felt compelled today to research the topic of abortion and its link to infertility. I have heard about persons who had abortion and when they wanted to have kids later on, they were having difficult. Now I would state up front that I am a Christian and do not believe in abortion, but this article is not about judging anyone, but rather it is to offer insights into other possible conditions that may affect our uterus so that persons can become more informed and should they have a previous abortion/s and are having difficulties, they can decide to visit their health care provider for an assessment.

This topic is controversial and there are some who believe it does and others believe it doesn't cause abortion. The thing is though that many persons find a whole lot of ways to get an abortion done and when they are really desperate the methods take many forms. While some are not done by trained professionals, others involve some techniques that are relatively inexpensive for the birth mother, but also detrimental to their health.

Now what I have done is compiled information from different sites. Although it is not expected that abortion will infertility, it is a surgical procedure and as such there are some associated complications that may affect future fertility. Again, I am not here to judge or to condemn for we have all made some form of mistake one way or the other. Still, I will ask persons to reconsider  if you are currently thinking of it. You do not want to live with regrets.

 Amin GafarFertility treatment expert.

"It's very unlikely that a past termination, if it was straightforward, will affect your chances of getting pregnant. Most women who have had a termination go on to have a baby when they are ready without any problems. Having conceived before proves that you ovulate and can get pregnant. So, rest assured that if it's taking longer than you'd like to get pregnant, it's unlikely to be because of the termination. Occasionally, though, if the termination was not straightforward, it may affect your fertility. An incomplete termination (retained products of conception) can increase the risk of infection and scarring. An infection setting in after the procedure, such as pelvic inflammatory disease (PID), can cause a problem. If it's not treated early, PID can lead to blockages in and around the fallopian tubes. And there may be scarring at the top of your cervix (the entrance to your uterus) or inside your uterus."See for more information :http://www.babycentre.co.uk/x1013967/does-a-past-termination-affect-my-chances-of-getting-pregnant

That Abortion that Robbed me of my Children

In my many years of practice of medical ultrasound I have attended to thousands of women suffering from infertility due to many causes including abortion, legal or illegal. I had this patient, she has being married for over 7 years with no child. She came to me for ultrasound scan test, after the tests, I noticed that the endometrial cavity was thin and fibrosed with evidence of adhesion. I asked her if she had had a miscarriage, she told me that she had never being pregnant since she got married. I now asked her if she had ever being pregnant before she got married, and what happened to her. That was when she opened up and told me the whole story.
She was a virgin and had this boyfriend, after much pressure from the young man for some closer intimate moments with her, she finally gave in to keep the relationship. They had sex only once, but unfortunately for her she became pregnant. In an effort to hide it from their parents , since they were not ready to get married yet and were very young, they both agreed to have an abortion. They went to a clinic [qualified or not we cannot tell], and had the abortion, after that all was well. She separated from the young man , and had never had sex with any other man until she got married. Now for seven years she could not get pregnant, she thought she was cursed. She had done many tests and all results were normal but no improvement in her situation. Until she came to me and I made my findings.

In this article , I want to assure you that I am not here to talk about pro abortion nor con abortion issues. I am not here to condemn anyone, nor discuss moral issues of abortion. That is not my place. I am only interested in discussing about infertility, the causes, diagnostic tests, treatments especially a simple assisted reproductive technique called Intrauterine Insemination [IUI]. See for more information: http://www.nairaland.com/301409/abortion-robbed-me-children-infertility

Could an abortion increase the risk of problems in a subsequent pregnancy? Answers from Roger W. Harms, M.D.

• Vaginal bleeding during early pregnancy

• Preterm birth

• Low birth weight

• Placenta previa — when the placenta partially or completely covers the cervix, which can cause severe bleeding before or during delivery

See for more information: http://www.mayoclinic.org/healthy-living/getting-pregnant/expert-answers/abortion/faq-20058551

Generally, abortion isn't thought to cause fertility issues or complications in subsequent pregnancies. However, some research suggests a possible link between abortion and an increased risk of:

Struggling with Infertility: Do not lose hope

Last night, in a conversation with my husband, I made the statement, suppose when we are ready for another child, I can't have and his response was If God will it, then it would be. This morning I found myself reflecting on my journey from childless to my beautiful baby girl and tears flow from my eyes. I lifted my eyes to heaven and I said thank you Lord and began praying. I said to the Lord, please do not let me forget your goodness to me. It is so easy to forget at times, but like Jeremiah, my testimony is like fire shut up in my bones and I need to encourage those who are currently discourage, to instill hope in those who have lost it and to inspire faith in those who have doubts. The Lord still heals, he still blesses, he still hear our prayers and cries, he still is miraculous, he is still able to grant us the desires of our hearts. His word is still true and so he will bless you with the heritage of your womb, just trust him and believe.

Several months ago, I was in a position where I was confused, doubtful and miserable. Why me? How come things always happen to me? What is your plan for my life Lord that I must go through this journey? Am I meant to have kids? Those are just a few of the questions plagued my mind daily. I cried out to the Lord, like Hannah, in fast and prayer. I began repenting for sin whether it was in words, thoughts or actions, not just for myself, but up the generational tree. If i ever thought about abortion, I repented. If I ever looked or heard anyone in my family called someone a mule, I repented. The reality was before my eyes and I knew I needed a cleansing from the Lord and his grace to be extended to me. I needed a fresh start. 

I was never quiet with my issue and it was a good thing because then God place someone in my way, someone who I didn't expect anything from. He placed it on the heart of one of my lecturer to ask if I was pregnant; a question that she herself said that she does not usually asked people, a question I could have simply said no and leave at that. Instead, in addition to no and I let her know that it was a fibroid and immediately she called a doctor and organized an appointment for me to the following day. I entered his office not knowing what to expect, but hoping for something positive. I knew it must have been God, for that senior surgeon decided to do my surgery and to accept only what the insurance can cover. Isn't my God magnificent? I didn't even know how much the surgery cost until after....JA$500 000 and I paid nothing from my pocket. A few months after I got pregnant and I give birth to my sweet Gabrielle. I am forever grateful to God. I do think someone needs to be reminded that God is still ready and available to bless you abundantly. Open your eyes to the doors that he is opening before you. It is a good thing to be private at times, but do not let privacy make you miss the open doors God is setting before you. Continue to trust God and may the wombs of those who desire children be blessed with child

Unwanted Hysterectomy

Until recently, I could not fathom what it is like to have a hysterectomy. I reflected on my hospital experience, a few hours before my myomectomy where I was given the speech by the doctor and asked to sign a paper for a hysterectomy. I had already stressed, over and over again, the need to keep my womb and I chose not to even think about the chance that a hysterectomy would have to be performed. I wanted to so that I can prepare myself mentally, but I could not. 

Recently, I visited my friend in the hospital. She went in for a myomectomy and ended up with a hysterectomy because of complications. At less than 30 years old and no kids, she had lost her womb. I looked at her. I wanted to say something positive, but I found myself lost for words. Even as a Christian, I could not muster up a few words. I wondered, what could anyone say to me if all hope of birthing a child was lost... probably nothing. I could not think of anything I would have wanted to hear and so there was nothing I could have said, except looked at her and offer her a listening ear. Yet, she was strong and thankful to God for life, realising that it could have been worse. 

A week after, I met another friend who underwent hysterectomy. A few years have passed, but it did not take away the emptiness of wanting a child and so she adopted one and she is extremely happy. You could not tell that she did not give birth to that child. The way she expressed her love was incredible and it let me know that the world is not over with a hysterectomy. That overtime, things will become clearer. Even though you cannot change what has happened, happiness is still within your grasp. It would not be east to accept, but you will get through.

Still, these two situations have shown me the need for persons to share their stories. I ask of you today, to use my blog to share your stories. If you cannot post, email me and I will post it for you. I am a myomectomy patient and I can relate to those who had the surgery. A year after, I was blessed with a baby girl (almost 5months to date). There are persons who have had multiple surgeries and are still waiting for their blessing, so while I might be able to give hope to many and encourage others through my personal story, there are many out there who can also help. You can let people know how you have found support through whatever you are going through. I remember the many silent tears I have cried and I know how uplifted I felt when I was able to speak to someone who is going through a similar condition. So again I asked, please share your stories. You can do it anonymously. Let us continue to support each other as women.

Pregnant after myomectomy: Baby Gabrielle is here

A year after my myomectomy, I got pregnant and I am happy to relate to all my followers that Baby Gabrielle is here and doing well. To all those who are struggling, there is still hope. I have proven that God is still into miracles and there is still hope for all.

I understand your struggle as I have been there. I understand the tears, not knowing who to talk to and have to listen to insensitive comments from people who does not understand what you are going through even though they are just trying to help.

In all of this, I have learnt to rely mainly on God as a source of strength and hope. I cherished and I am very grateful to my husband who never lost hope, never give up, was always a strong supporter and prayer warriour and my surgeon Professor Joseph Frederick who heads the fertility clinic at the University of the West Indies hospital in Kingston Jamaica ( he did my surgery and took my baby and as good as he is, he still called me a miracle woman and that's how you know God is above doctors because even with their greatest skills, sometimes they too lose hope, but God never does). I am also thankful to all of you who continue to read and support the blog, and supported me through my ordeal, your comments, emails, phone calls meant a lot and through it all it was good to know that I am not alone even though we do not wish any of these sickness on each other.

I hope you follow my page on Facebook because even though I was not getting a chance to blog especially during the pregnancy, I continued to share very interesting and important information about different issues of the uterus on the Facebook page. The information includes new research, healthy lifestyles, what PCOS, endometriosis, fibroids etc sufferers are experiencing, trying and what is working...So keep posted to that page and whenever you have a story share. If it is one thing I will encourage you to do even though it is the hardest thing to do (especially with how critical people can be) is TALK! Do not fear talking. If I had chosen to give little details when my lecturer asked me if I was pregnant, I never would have met Professor Frederick, one of the best surgeons and a researcher in the field of fibroid in Jamaica, I never would have  known the many people who are going through the same and can encourage them to stay strong and maybe today I would not have been looking at the face of my beautiful daughter. Just as me talking might have helped you, you talking may help someone else. Tell us your success story, your struggles, your treatments and how they are working and let us continue to help and encourage each other.

Being Pregnant after Myomectomy

When you have gone through some issue, no one understands you like you, unless there is someone else who have gone through the exact or similar things. This is what we are about and I share my personal story from time to time because I know the information I sought and still seek as a person who have suffered with fibroids, endometriosis and ovarian cysts. Prior to and following my myomectomy, I researched persons success story, what was the myomectomy like, did they get pregnant after healing and how soon, what are the risks, what was their pregnancy like? Today, though I am still on the journey, I wish to share a little.

Fear will creep in. Your thoughts of miscarriage will come and go and you have to be ready to shut it out. For me, I depend on the word of God. One thing I know is that you cannot afford to be stressed and you have to enjoy your pregnancy. You will not only worry about miscarriage, but the baby's development and most of all, what you are not doing right. Sometimes, I am afraid to lift a broom, afraid to walk for distances that were a normal part of my life and afraid to have sex...yes...but don't worry. Concerning sex, you might not be stressing your partner with lack of it because even he is careful and fearful. It takes a little coaxing even after the doctor says it is ok to have sex to get your partner to give you some and we know sex is not something men normally turn down.

Even after passing your 3 months (the high risk end), although you might feel a bit more confident, there will still be time that you wonder about the strength of your uterus as it stretches, especially if your baby is growing fast. After about 19 weeks, your baby will start to kick and they get harder as he grows, sometimes so close to the bladder, it will send you to be bathroom, but those kicks is your most wonderful experience. You rely on them to tell you the baby is alive and well since he is so active. 

I don't know what it is like to be pregnant before the surgery. I had the surgery April 2012, got pregnant, February 2013, roughly 4 months after my recovery and for me the myomectomy helped because I could not have gotten pregnant before it, mainly because of the endometriosis. The journey so far has been smooth, nothing out of the normal. I will be doing an ultrasound soon to look on the fetal anatomy and other aspects of the child development and hopefully will also know the gender. I will keep you abreast, but I leave this with you....Don't lose hope. If you plan to do the surgery, the most important thought for you, would be finding a skilled surgeon, absolutely important whenever cutting is involve and I will also advise you to pray...it would seem simple and fruitless for some, but I dont know what I would do without that connection to God.


UPDATE

Just adding a quick update following our ultrasound...It is a girllllllllllllll...Bless God. Below is our baby registry should you feel the need to bless our little one with a gift:

Rose-Ann Smith and Rahsaan Smith's Baby Registry Link: http://www.amazon.com/registry/baby/2D65RQNY6BHGY

Thanks to all of your for your prayers, support, comments, emails etc...It is greatly appreciated.

Miracle Baby

If you have been following my blogs, especially the personal section, you will understand what I have gone through. From removing a fibroid via abdominal myomectomy, the size of a grape fruit, to finding out during that surgery that I also had endometriosis and ovarian cyst on both ovaries. So at the end of my surgery, there was a sense of relief, but also shock as to all that was taking place in my body. I had a good surgeon and again if you read, you would know how I attributed everything to the glory of God. He helped me in finding the surgeon, in paying less that the actual payment of the surgery (nothing was paid out of my pocket) and to remain calm while in the hospital and recovering following the surgery. I cannot stressed how much it was God.

Well following the surgery, I was put first on lupron, then later on clomid and was told go ahead and try again to start a family. In my spirit, I felt it would be easier, especially with the assistance of the clomid, but month after month, my period would come and I would be disappointed. I knew I was ovulating even without the clomid because I tracked it using ovulation kits monthly. I read all the different positions to put your legs following sex, whether up on a wall, cushion under hip etc...I am sure for those of you are trying, you have read them also. I would scheduled sex so that we do not have too little, but also not too much, once a day every other day leading up to, during and after ovulation. Still NOTHING!!! The tears began to come and I remember thinking is this it. Would I ever be able to give my husband a child? Would I ever be able to look at my own child and say this is the product of my marriage? Frustrated, I didn't take the clomid for a month, but even then nothing. I took it the following month and was closely monitored by the doctor to check the development of my eggs and if I was ovulating. That month, all was well according to the doctor, but still, NOTHING!!!. I cried again as my husband tried to comfort me. Sure he was worried, but it appeared his faith was more than mine. I returned to the doctor. He said to me, it seems like the clomid is not having any effect on your eggs but at the same time I was ovulating. He suggested injectibles and in vitro, both expensive procedures. Hearing those suggestions, I was somewhat fearful. I said  to myself, if the doctor should say this, it is serious. Where was I to get the money? I prayed, something I was doing all along, but this time it was more like a Hannah prayer. The prayer that left you looking drunk, drained. Morning after morning, I fell on my face and I prayed. My faith was being threatened. I needed to be reminded what was important in this life because for me, at this juncture, it was having a child and I wasn't sure if that was God's will.

That month, January, 2013 when I noticed despite ALL THE RIGHT THINGS I had done, my period came, I threw in the towel. I said to my husband, we are not going to try this month and I don't know when I would be ready again. I needed a break. I said God, this is it. If It is your will for me to have a child, then it would happen, have your way. If not, then let me find fulfillment in whatever you want me to do, which require that I am childless. Your will be done. I put the clomid  and the ovulation kit away. I refused to read anything pertaining to pregnancy and fertility. I said this month, I am going to have sex when and how I pleased. Half the people in this world who got pregnant, never planned nor did they put cushion under their bottoms, feet on wall or lie down 20 to 30 minutes after. I enjoyed my husband to the fullest that month, having sex every day sometime and more than once in the day. It was fun just making love and not thinking about baby, especially as I was going on a short vacation and would be away from him.

On my vacation, I remember sitting in the kitchen with my mother who wanted to know what was happening with me and pregnancy. She asked what causes these things (endo, fibroids etc), how come I get them and she didn't, what was the doctor saying, what are my options. For most of the questions, I had no answer. I tried to enjoy the vacation with my niece and nephew. I hang with my friends, although I thought I was getting too old as I was constantly tired. I had a headache, took aleve. No way I could be pregnant, I thought. I didn't do anything right that month. Then my period due day came and pass, but no period. I still doubted. I played with the idea of buying a test. My boobs were so sore that I couldn't touch them, I was tired etc, but again I said, how many months I felt pregnant to the point of nausea and nothing, just pms. Still, I convinced myself to buy a test and felt if it is negative, what the heck, there are no expectations. Got home, took it and less than a minute I got a POSITIVE. I was in silence. Did I do it right? My excitement was away off. Jeez, I should have bought another one. Should I tell my mother? Instead, I called my brother who had two kids already. He smiled and said it look right, but buy another. He went to get it, but all places were closed. I was leaving for Jamaica the following day. I text my husband with a picture of the test and told him, I might be pregnant. I told him to buy another test to confirm. I wanted to jump and scream, but I didn't want to be hurt by a false positive.  Before I returned to Jamaica, I told my mom and immediately she made the sign of the cross and say thank you Jesus. I said, it is just one, let us confirm with the doctor etc, first, before any celebration. I got to Jamaica, took the test, a more expensive one, and again within secs two strong lines appear. I smiled. I thank God. I was so happy, but I wanted to hear from the doctor.

My first visit, confirm a pregnancy at 6 weeks with an empty gestational sac. I was worried, but the doctor said then I am so lucky because so many persons had to repeat the surgery. He put me on folic acid and cyclogest immediately and asked me to return so that we can see if anything form in the sac and to hear a heart beat. The following week, I went back to the doctor and to God be the glory, there was a heartbeat. Now I was SUPER EXCIIIIIIIIIIIIIIIITED. He put me on low dose aspirin to take along with the cyclogest. Although I never had a miscarriage, he was taking every precaution. Yesterday, 14th May, I returned for my 12 weeks check up and things are progressing well, but this is what I want you to hear. The doctor said to me, THIS IS NOTHING SHORT OF A MIRACLE. YOU ARE ONE LUCKY YOUNG LADY. He went as far as telling me because the fibroid was so big, he had his doubts, but it is a miracle. Since the day, I found out, I was giving God praise. I knew my child is a special blessing. Yesterday though, just hearing it from the doctor, who did my surgery, I was just filled with praise. I want to let you know there is a God who is able. I am trusting him to take me through a healthy pregnancy and whatever the outcome to him be the Glory. Don't lose your faith in God, even though you might have lost it in yourself. He is able. Keep me in your prayers that I do not miscarried but have a full term, healthy pregnancy and I will be sure to give you updates.

Have I waited too long?

There are many of us who spend our time seeking to improve ourselves in this modern world. We want to have a good education, a good career, a nice house and car, a good husband and lovely children. So we make our decisions and prioritize. Education and career seems to be at the forefront, and there is nothing wrong with that. We all want to have a better life than the one of our parents and we want our kids to grow up having all that they want, no worries about clothing and school fees etc. Of course, for some of us, we watched our parents struggle on little income with 2 and more siblings and so we want different. Still, when we have it all or reach the point where we feel we can afford to have kids, and are now face with the issues of child bearing, has it ever cross your minds, have I waited too long? It crossed my mind several times.

Many of us have lived our lives believing that what we were facing in our younger days, the terribly painful periods, the irregular periods (which some of us were so happy for), the heavy clotty periods, abdominal cramps, missing school, missing work and it went on and on, but we thought it was a common thing. In fact, some doctors even told us it was common. So we spent our lives, trying to better ourselves and earn enough so we can have a satisfactory, happy life with our kids in the future. We got married, but we never rush to have kids because it is a good thing to spend at least 2 years enjoying your marriage, at least so we were told, no rush. Then the day came and we thought it would be easy. Once that birth control stop, bam! To our distress, it was not. Months passed and we realized, it can't be normal. We visit doctors who want us to wait at least a year before doing any fertility testing, but we are already emotional, distress, scared. Would I ever be able to give my husband a kid? Lord, even if it is one, we beg. I don't want to get too old. Have I waited too long?

Some questions we can only answer for ourselves. However, there are some important points I grasped along the way, which may influence our decisions:

• Normal to you is not always normal. Visit your gynae regularly. Express your symptoms in details and run the tests. If symptoms persist and your present doctor kept telling you it is normal, while refusing to send you for tests, change your doctor. Visit a specialist. Get your answers. A peaceful mind is stress free.
• Try live healthy from the beginning. It is not always easy and sure there are times we are doing it and the problem exists anyway, but an unhealthy lifestyle can create problems or worsen existing ones. 
• If you are already married, especially if that's your religions belief, make sure you know your status before you decide to wait for kids. Really, really important. I am sure everyone decisions would be influenced by this information.
• Finally, while education and career is important, think, would you choose it over having a child? I look at my own life. I grew up with little, within a struggling home, but neither myself nor my siblings ever go hungry or without clothes on our back. We were happy with the little we have. So while we all want to give our children the world, we wouldn't want to have the world and no kids. Maybe it is better to have a kid or two, who we are able to bring up in a happy home though the resources are limited. I am sure if we have information on our fertility earlier, we would have make different decisions in spite of what  resources we have. So again, don't take anything simple, visit your doctor. 

Have a blessed day guys. Also please follow us on Facebook. While I might not publish post as regularly on the blog, there are some interesting tips, information, researches, stories from other persons that I might feed from one site into my facebook page. 

All you need to know about infertility

What is infertility?

Infertility means not being able to get pregnant after one year of trying (or six months if a woman is 35 or older). Women who can get pregnant but are unable to stay pregnant may also be infertile.

Pregnancy is the result of a process that has many steps. To get pregnant:

• A woman's body must release an egg from one of her ovaries (ovulation).
• The egg must go through a fallopian tube toward the uterus (womb).
• A man's sperm must join with (fertilize) the egg along the way.
• The fertilized egg must attach to the inside of the uterus (implantation).

Infertility can happen if there are problems with any of these steps.

What causes infertility in women?

Most cases of female infertility are caused by problems with ovulation. Without ovulation, there are no eggs to be fertilized. Some signs that a woman is not ovulating normally include irregular or absent menstrual periods.
Ovulation problems are often caused by polycystic ovarian syndrome (PCOS). PCOS is a hormone imbalance problem which can interfere with normal ovulation. PCOS is the most common cause of female infertility. Primary ovarian insufficiency (POI) is another cause of ovulation problems. POI occurs when a woman's ovaries stop working normally before she is 40. POI is not the same as early menopause.
Less common causes of fertility problems in women include:

• Blocked fallopian tubes due to pelvic inflammatory disease, endometriosis, or surgery for an ectopic pregnancy
• Physical problems with the uterus
• Uterine fibroids, which are non-cancerous clumps of tissue and muscle on the walls of the uterus.

What things increase a woman's risk of infertility?

Many things can change a woman's ability to have a baby. These include:

• Age
• Smoking
• Excess alcohol use
• Stress
• Poor diet
• Athletic training
• Being overweight or underweight
• Sexually transmitted infections (STIs)
• Health problems that cause hormonal changes, such as polycystic ovarian syndrome and primary ovarian insufficiency

How does age affect a woman's ability to have children?

Many women are waiting until their 30s and 40s to have children. In fact, about 20 percent of women in the United States now have their first child after age 35. So age is a growing cause of fertility problems. About one-third of couples in which the woman is over 35 have fertility problems.

Aging decreases a woman's chances of having a baby in the following ways:

• Her ovaries become less able to release eggs
• She has a smaller number of eggs left
• Her eggs are not as healthy
• She is more likely to have health conditions that can cause fertility problems
• She is more likely to have a miscarriage

How long should women try to get pregnant before calling their doctors?

Most experts suggest at least one year. Women 35 or older should see their doctors after six months of trying. A woman's chances of having a baby decrease rapidly every year after the age of 30.

Some health problems also increase the risk of infertility. So, women should talk to their doctors if they have:

• Irregular periods or no menstrual periods
• Very painful periods
• Endometriosis
• Pelvic inflammatory disease
• More than one miscarriage

It is a good idea for any woman to talk to a doctor before trying to get pregnant. Doctors can help you get your body ready for a healthy baby. They can also answer questions on fertility and give tips on conceiving.

How will doctors find out if a woman and her partner have fertility problems?

Doctors will do an infertility checkup. This involves a physical exam. The doctor will also ask for both partners' health and sexual histories. Sometimes this can find the problem. However, most of the time, the doctor will need to do more tests.
In men, doctors usually begin by testing the semen. They look at the number, shape, and movement of the sperm. Sometimes doctors also suggest testing the level of a man's hormones.
In women, the first step is to find out if she is ovulating each month. There are a few ways to do this. A woman can track her ovulation at home by:

• Writing down changes in her morning body temperature for several months
• Writing down how her cervical mucus looks for several months
• Using a home ovulation test kit (available at drug or grocery stores)

Doctors can also check ovulation with blood tests. Or they can do an ultrasound of the ovaries. If ovulation is normal, there are other fertility tests available.
Some common tests of fertility in women include:

• Hysterosalpingography (HIS-tur-oh-sal-ping-GOGH-ru-fee): This is an x-ray of the uterus and fallopian tubes. Doctors inject a special dye into the uterus through the vagina. This dye shows up in the x-ray. Doctors can then watch to see if the dye moves freely through the uterus and fallopian tubes. This can help them find physical blocks that may be causing infertility. Blocks in the system can keep the egg from moving from the fallopian tube to the uterus. A block could also keep the sperm from reaching the egg.
• Laparoscopy (lap-uh-ROS-kuh-pee): A minor surgery to see inside the abdomen. The doctor does this with a small tool with a light called a laparoscope (LAP-uh-roh-skohp). She or he makes a small cut in the lower abdomen and inserts the laparoscope. With the laparoscope, the doctor can check the ovaries, fallopian tubes, and uterus for disease and physical problems. Doctors can usually find scarring and endometriosis by laparoscopy.

Finding the cause of infertility can be a long and emotional process. It may take time to complete all the needed tests. So don't worry if the problem is not found right away.

Source: http://www.womenshealth.gov/publications/our-publications/fact-sheet/infertility.cfm