Browse > Home / Learning More / Invasive Infertility Tests

Invasive Infertility Tests

June 8, 2008

This FAQ was compiled by Rebecca Smith Waddell for the alt.infertility and misc.health.infertility usenet newsgroups.

For each test, there is a price range listed next to the test name, and a short description of the procedure. Please note that the prices listed are without insurance and reflect a very small sample. Following that you will find personal experiences that were posted to the newsgroups or sent to me via e-mail. I have tried to get permission from everyone to use their posts. I thank everyone who was willing to help with this!

If you would like to contribute prices or your story, please fill out our form. Thank you!

Also, many of the posts used are from outside the United States. In those cases I have added the country as a way of letting international readers know that the tests are largely the same in many countries.

These aren’t really in any order other than being grouped into the categories of endometrial biopsy, hysterosalpingogram, hysteroscopy, laparoscopy, sonohysterogram, and dilation & curettage.

It is important to note that women are more likely to submit stories if their experiences were unpleasant. I have been told on several occasions that this FAQ is unnecessarily frightening, but that really depends on how you read it. Both positive and negative stories are included — one should not focus only on the negative. One also should not expect to be one of the worst cases presented here, but it is still probably worth knowing what the possible complications are. In most cases, the anticipation and worry before a procedure is worse than the event and recovery. As hard as it is to do, most women will benefit from being knowledgeable about the procedures while also trying to remain calm about the possibilities.


 Table of Contents


Endometrial Biopsy (EMB)


Hysterosalpingogram (HSG)


Sonohysterogram / Saline Ultrasound (SHG / Sono-HSG)


Hysteroscopy (HSC)


Laparoscopy (lap)

Dilation & Curettage (D&C)



 Endometrial Biopsy (EMB) - $75-$305

What is an endometrial biopsy and why is it needed?

The endometrial biopsy is used to “date” the lining to see if it is out of sync hormonally. It is considered out of phase if it the lining appears to be more than 2 days off. It is common to repeat the biopsy in another cycle, if it is found to be out of phase, before a diagnosis of a luteal phase defect is made. These tests are somewhat insensitive and I was told “about as good as the pathologist reading it.”

The biopsy is performed in the second half of the cycle, usually just a few days before menstruation is expected. It can be done in the same cycle as one in which you are trying to get pregnant because the risk of miscarriage from the biopsy is only about 1% (combine that with your chances of getting pregnant in a given cycle and there isn’t much to worry about at all).

The biopsy is done by inserting a narrow catheter through the cervix and into the uterus. A small sample of tissue is sucked into the tube and sent to the lab for analysis. Expect a bit of discomfort with this test — about the same as a bad menstrual cramp. The biopsy doesn’t take long, and the pain usually subsides when the procedure ends. You may have some spotting afterward.

Some suggest taking Advil or Aleve about a half hour before the test to relieve discomfort. Check with your doctor first, since this may not be recommended during a cycle in which you are trying to get pregnant. My own experience is that the pain relievers didn’t make any difference.

What should I expect when I have an endometrial biopsy? How will it feel?

I’ve had an EMB at the end of each of my last two cycles.

The first one was OK. It hurt about the same as a bad menstrual cramp while the tissue was being taken, but it was over very quickly. Afterward I felt back to normal pretty much immediately, other than sort of a heightened sensation of my cervix. That may sound strange, but that’s the best way I can think of describing it. I didn’t take any painkillers. A few hours later I did get about 4-5 rapid twinges, but that’s about it. I spotted for maybe 6 hours. The blood you see is often from the clamp, not the biopsy.

For the one I had two weeks ago, I took 800 mg of Advil. It didn’t work because this biopsy was more painful. I think it was worse because it took a little longer — the doctor was on vacation and came in just to do this test, sans nurse, so no one handing him tools. Again the cramps ended immediately after the catheter was removed and I got up and went out to lunch with my DH. The only spotting I had was wiped away after my first urination. The next day I was driving back roads and bumping around a lot and noticed lower back pains and a little heaviness in my abdomen. I was sort of blaming it on the EMB, but it retrospect it seems like PMS. I got my period 4 days early, and the doctor felt it was probably because of the EMB and all my activity. I also had a little brown spotting before each period which I have never done before, nor since.

I’m in Chesapeake, had my biopsy done in the office. The whole procedure took about as long as a normal vaginal exam. Depending on if your doctor numbs your cervix or not with some spray Lidocaine and depending on how bad you feel when you cramp are going to be big factors. I cramp like a son of a gun, but I took some of my cramping medicine about an hour before the test. The test was not comfortable, but it was quick and just gave me a mild crampy feeling on the way home. I took a nap and took it easy that day, because it felt like I could feel a sore inside near my cervix…from where he held onto it with the clamp. I spotted a little from where the biopsy was taken, but felt completely normal by the next day. All and all, I put a lot more worry into it than I needed too. I’m a wuss when it comes to pain. I’m a nurse but I hate needles…now I’m on day 6 of my IVF cycle and getting three needles a day. Ack! I can’t believe I’m not totally freaked out yet.

At least I haven’t passed out!

I have had a few of those EMB’s done too. And I wanted to suggest that when they tell you to stay on the table and relax for a couple of minutes to take their suggestion! On my first I tried to get up too quick and felt “lightheaded” but before I scare everyone I want to let you know that I also get faint when they take blood, some of us are just blessed with this “reflex”, I am not afraid of needles or anything (you get over a lot of this during infertility treatment don’t you?). My RE said it is not that uncommon, maybe he was just trying to make me feel better :)

By the way they have never particularly hurt me, one quick cramp and it is over.

I had mine today. No painkillers, very nervous, but it was an unpleasant minute when the doctor put the catheter in, and after that it was all right. I sat with a hot bottle on my belly for two hours after, but that was more because I liked it than because I needed it. I had worse periods!

(The Netherlands)

My test was very painful. I was told that it wouldn’t be too bad and that I should take a painkiller ahead of time. I forgot and really paid for it. It was all over fairly quickly and I thought I was fine (though I felt pain and I could feel that I was bleeding). I went to sit up and got really sick. I threw up and was very near fainting. I have a huge problem with needles and this was my reaction to this test was just as bad. The next day I was still feeling a bit of pain but the bleeding eventually stopped on that day. I would highly suggest the painkillers ahead of time and take someone with you to drive home just in case.

How does an endometrial biopsy compare to a hysterosalpingogram?
Which one is more uncomfortable?

I understood that it is different for each woman (both EMB and HSG). For some EMB is very painful and HSG is hardly felt, for others it is the other way around. For me, the EMB felt like one cramp (short, not nice but not to bad either) and I was fine afterwards.

For the HSG I took a painkiller (I asked my RE for one). They use a different sort of speculum, a tiny bit more uncomfortable than the normal one (it is more like a circle than a duck’s beak). Than they put a plastic cub on your uterusmouth. That is a rather nasty feeling, and you will keep feeling that as long as it is there. Attached to it is a tube, and the send the dye true that one. Since that can be painful for some they will try to do it as slowly as possible. To me they said that if I felt a real pain I should warn them and they would stop a minute or go more slowly. This part will take approximately 10 minute (It took less for me, it can take a bit more for others).

Afterwards they told me to walk, to make sure that the dye wouldn’t linger. I had to come back after 15 minutes and they would take a final picture to check.

I had mine done around three in the afternoon, and felt like I had a bad period the rest of the day. The next day I felt sort-of “bruised” inside, so I didn’t want to hop around to much. Today (2 days later) I feel nothing anymore.

All in all it wasn’t a ball, but I could do it again. I hope this gives you sort of a feel of what it can be like, but you shouldn’t forget that it is different for each individual.

(The Netherlands)

I also experienced very bad pain with the HSG. I was really worried about the EMB as well, but it was definitely not as painful as the HSG. I’ve heard you should take a couple of Advils before the procedure since you will experience minor cramping and spotting. Also, my gyno didn’t get back to me for a week with the results (just so you’re not expecting anything right away)

The HSG is a hundred times worse. For me, the biopsy was painful for just a minute (and not nearly intense as HSG).

If you take three Aleve or four Motrin one hour before the biopsy it helps a lot. I just did it and it was way better than the first time without. It is uncomfortable, more for some and less for others.

Ah, but for me the endo biopsy was the absolute worst thing as far as testing goes, and my first HSG went so well, I asked for the second one (one year later, a miscarriage and a laparotomy happened in that year). The endo biopsy however caused me to pass out on the table, and I bled pretty good for about a day, and the cramping was so bad on the way home, I almost called my husband to come get me, but since my Doctor was an hour and a half away from home at that point, I figured I would be better off getting home as soon as possible. But the good news, is that is very rare, and has to do with some people having more sensitive nerves than other and I tend to get dizzy from just about anything that causes a nerve to be hit, even if it didn’t hurt that much (quite similar to the funny bone effect - but in my whole body).

Now I can actually compare the two because I had my HSG on Wednesday. I see that most of the posts come down on the side of the HSG being worse, but it wasn’t for me. I think they are different, for one thing, so a bit hard to compare.

My experience was a very bad pain for a very short time with and EMB, but a milder, longer-lasting pain with the HSG that was pretty unpleasant but not as “painful”. I think it took a little longer to get over the HSG too, in that standing up for me brought on renewed cramping, but still nothing that bad. To me it felt more like the beginning of a period, while an EMB is probably more like the worst cramp of a period, but probably somewhat more painful than that.
 Hysterosalpingogram (HSG) - $200-$700

What is a hysterosalpingogram and why is it needed?

A hysterosalpingogram is where dye is injected into the uterus to look for anatomic problems, such as tube patency (if they are open), fibroids, polyps, or structural problems with the uterine cavity. This test is usually done in the first half of a woman’s cycle, between days 7-10. A small catheter is inserted through the cervix in order to inject the dye, or, in some places, a balloon catheter is used to push dye through the cervix without actially threading anything through it. You’ll be expected to turn a little as the doctor / radiologist takes pictures or views the process through something that looks a lot like an ultrasound. It should only last about 5 minutes. Some cramping and discomfort is common during the procedure and for a little while afterward. Also, some spotting is to be expected. Your doctor may prescribe antibiotics and suggest a painkiller be taken. Be sure to tell your doctor if you are allergic to shellfish. Women taking metformin (brand name Glucophage or GlucophageXR) should discuss whether the medication should be discontinued for a couple of days before the procedure.

The hysterosalpingogram is usually better for checking whether tubes are open than the sonohysterogram, where the other is probably better for checking for fibroids and polyps.

What should I expect when I have a hysterosalpingogram? How will it feel?

I had my HSG on Wednesday and I would have to say it is somewhat uncomfortable, but not that bad. I’d liken it to period cramps that last about 5 minutes. I actually had very little problem while I was getting to watch the dye move through, but because of certain activities (including the power being out during all of this!!!!) I didn’t get to see the dye flow through both tubes. I was left on the table for a minute while the radiologist went to check the still films he took, and I started panicking a little. I was supposed to be able to have my DH in the room, but at the last minute he was kicked out so an extra tech with a flashlight could assist the doctor. So between my not being there and not having seen the dye move all the way through one of the tubes I tensed and that’s when I had the most cramping. When I relaxed, it let up (luckily my doctor is very calming). I did have some more cramping when I got up from the table, but it was all over before I finished dressing. I would say I easily could have gone back to work if I wanted to, and the day after the HSG I went hiking in the woods and along the rock-bound coast of Maine with no discomfort.

For 2 weeks I have been so afraid of this day. This will be the day that will tell me if I have more obstacles ahead of me. I am scheduled to be at the Outpatient Diagnostic Center at Norfolk Sentara at 1230 today.

I got to the hospital 15 minutes early and went to radiology. Ok so I had to find the right department. I found the correct department. Checked in with the receptionist after that we did the normal payment paperwork. I was shown to the waiting area. That was the longest wait of my life. I was scheduled for the procedure at 1245. It was 115 before I was sent to the dressing room. I was given a gown and a robe. I took the robe into the dressing room. It did not fit. I went in the closest room and asked for another gown. There was a nurse and a patient in there. Oops! But, I got another gown. The restroom I changed in was dirty but I did finally get changed. I stood in the dressing hall way waiting for some one for close to 10 minutes. Finally a nurse came to get me. She took me into the room and had me sit down. One of the doctors from the Jones Institute came over to do the HSG. He had me sign the form for the Jones Institute. I guess he had to make sure he got his money too. I had to laugh at that.

The doctor was great and explained everything to me as it happened. I laid on a x-ray table and he inserted the speculum cold and uncomfortable not too bad. He pinched my cervix and that started the dull cramping. He got the tube in and pulled out the speculum. The cramping was very noticeable by then and I had to hold myself still so that I would not rock. The radiologist came in and the doctor from the Jones Institute injected the dye as the radiologist captured it on the film. I had to turn to the left and the right this took all of three minutes once the radiologist was in the room. The radiologist left and he removed the tube. At first I just laid there as the pain increased and it was accompanied by pressure on my rectum. I had never heard of that before. The doctor had the films on the screen and showed me each one. The films show that I have perfect tubes and a perfectly shaped uterus with no noticeable adhesions.

The doctor left and I stayed there flat for a few seconds. The nurse said I could take my time. I did. I slowly sat up and I had to lie back down. Then I sat up again and leaned back down. I did this for a few seconds. One thing that helped a lot was an elevated butterfly position with my legs and leaning into the opening. For some reason that relieved the pressure. It was difficult to get to the restroom and change. I had minor spotting and had to take a vicadin after getting dressed. It felt a lot better to stand and walk than to sit. It has been 10 hours and there is still minor cramping and the bleeding has stopped. Over all the procedure was not horrible but I would not want to do it every cycle.

I had HSG done twice. In the first one (before my surgery for a fibroid) one of my tubes had minimal passage. Also the radiologist was somewhat harsh. I felt very uncomfortable and had severe discomfort in my stomach (actually did -sorry- threw up) after the HSG.

In the second one the blocking on my tube had gone after the operation, and my OB performed it herself. She is very nice. I had mild discomfort, and if I had not had the bad experience the first time, I would not mind at all.

I was told the solution they inject may be different on each occasion and that may also make a difference. BTW, all this took place abroad, it may be easier here.

I just had one done last week. I’m the world’s biggest coward when it comes to medical procedures, and it didn’t help that my Dr went on and on about how painful it is. But I took about 3 Ibuprofen and it was fine — just mild cramping. My dh came with me and got me involved in a conversation to distract me — this helped a lot too, I think.

I had an HSG, they found my tubes were clear - but I had a lot of pain during the procedure. It was worse than very bad cramps and I felt light headed during and immediately after the procedure. I wish someone had warned me it could be that bad - but I know it’s not the same for everyone. My gyno prescribed antibiotics ahead of time, and taking Advil may help a little as well (before and after).

I had one in April—for me it was very painful, BUT only for five minutes (I may have a blocked tube, which they say makes it more painful—but, because it was so painful they can’t be sure my tube was blocked because I may have had a muscle spasm which blocked the dye.) good news—I didn’t feel any pain as soon as it was finished (unlike endometrial biopsy)

Well, yesterday I had my HSG.

I tried to stay as calm as possible, knowing that I had had a painkiller, that it could hurt very much or not at all and that I wanted to know the results badly. But because my tubes were infected twice (10 years ago) I was pretty much convinced that my tubes were blocked, and that would make the procedure more painful……

I just hoped that it wouldn’t be too bad, and that it would clearly show that though my tubes were blocked my womb was ok (as a DES daughter I have a bigger chance of deformations in that area).

Though the pain was not the nicest thing ever done to me, it was comparable to a heavy period (in other words: I could handle it well enough). And than the radiologist congratulated me: my womb was fine and my *tubes were clear*.

I was absolutely flabbergasted. I mean: the past 10 years I was convinced that my tubes were blocked. I actually was a bit pissed off that they wanted me to undergo this painful procedure since it was already so clear that I needed at least a laparoscopy (I can be very stubborn…. fortunately I decided to not tell them till afterwards…..).

And now I have these very ambivalent feelings. On one hand I am thrilled that my tubes are all right, on the other I am worried. Blocked tubes was such an easy, detectable cause. Now I am real uncertain about what causes the infertility. But I keep telling myself that I should be really exited and happy, since blocked tubes would most probably be worse. The main feeling I have is still surprise though, because I just was utterly convinced that I knew what was going on.

(The Netherlands)

This may sound crazy, but my gyn put a bedpan upside-down under my hips for the HSG and it was perfect! It flattened my back against the table so that everything was level and it was easy to maneuver around to get the right angle. She did lie about the pain though…she prompted me about everything except the actual dye injection which was the most painful part! I think the nurse’s hand is still healing.

Why is it that every thing I found published about HSGs started out with …”although somewhat painful…” *somewhat*? After the initial pain of the opening of the cervix, I though great this is going pretty well. Then, the dye. My Dr. did not prepare me for this at all. Just said I needed to schedule the procedure.

The nurses at the lab were great. I don’t know if they had been through this at all, at least they were more supportive than the male scheduler.

Oh well, after the intense pain during the procedure, I didn’t have much more, just a dull ache that finally went away after about 24 - hours (on the way by car to my DH’s 20-year high school reunion). No prescriptions - just Advil. I did find that walking helped in one or two ways: 1) actually eased the pain, or 2) took my mind off of the pain and onto to something else. Either way it’s over.

I recently posted the same HSG question & received a tremendous number of responses, good and bad. Last Friday I had my HSG & the worst part about it was the worrying all day long. Once I got to the hospital & changed into the gown, the whole procedure lasted about ten minutes. Some people mentioned things like cervical clamps & Novacaine, & some even recommended asking for a prescription of Valium, so I was a little worried. I took 4 Advil. My doctor inserted the speculum, opened it a little wider than usual, & washed off my cervix with Betadine. He then fed through a very skinny catheter, narrower than a swizzle stick. It was a little uncomfortable, but certainly not painful. Even when the dye was injected, all I felt was a little pressure. He injected the oil based dye once we saw my tube was open, again, just a little pressure. It was definitely worth having done. Now I at least have a little glimmer of hope after my November 95 ectopic. Make sure your RE uses the oil dye - it’s the one that’s supposed to increase chances of pg for three months!

My HSG was not too bad either, mind you, not something I would want to repeat! I took 3 Advils 1/2 hour before hand. Had some cramping and slight bleeding afterwards. I was truly terrified after reading some of the posts here. I guess everyone handles pain differently. My doctor performed the procedure which helped me relax even more.

Mine (last Monday) was truly a piece of cake. They could do it every week and I wouldn’t mind (except for the time and the cost). I took 2 600 mg Motrin about 1/2 hr before (which isn’t a lot of time for the Motrin to kick in). They numbed my cervix, which was the worst of the pain and when I cramped a little they slowed down and then it was ok. It also was pretty fast.

Also, my doc said that the HSG by itself increases fertility (sometimes) if it is the oil kind (not water). I don’t know by what percent but apparently the effect lasts about 6 months. (Obviously this is if everything checks checks out normally, there are eggs and so on.)

My HSG was kind of a nightmare. I forgot to take the therapeutic dose of advil that they had recommended to take before the test, and boy did I pay for it! I had cramping for 2 days. Some of it may have been caused from the depression that set in when I found out that both of my tubes were blocked! What was also a horror was when my OB/GYN looked at me, in front of a technician and a nurse and asked me if I ever had chlamidia, ghonareah or any other STD, and said oh, don’t worry they are doing amazing things with IVF. I was horrified! No, I’ve never had any of those diseases and I was shocked that she would ask me that in front of other people. I had to be consoled by the nurse who said that it could because my tubes cramped up or something else.

Anyhow, the one good thing that came out of it was she recommended me to see my RE, who is wonderful! I also started doing some research and found out that tubes can be blocked by just about anything, including appendicitis, which I had in 1993. My appendix was gangrenous and was within hours of exploding.

Will having a hysterosalpingogram effect my chances of getting pregnant? If so why and for how long?

Supposedly an HSG can increase your chances of getting pregnant for the first 3 cycles after the procedure. I’ve seen some people say it ups your odds of success per cycle to about 30% because it “blows out the cobwebs” in the tubes.

Yes, it worked for me! The first time I got pregnant was 2 months after an HSG (which showed the tubes were clear) and the second time the month after my LAP (where they also insert dye into your tubes - tubes were still open). Those were the only 2 times I was pregnant. Unfortunately the first pregnancy ended in miscarriage and the second one was an ectopic (so there must be something wrong with my tubes after all), but what matters is that pregnancy really does happen more frequently after an HSG.

(Portugal)

Yep, our little guy was conceived the same month that I had the HSG. I researched it and found that studies had shown a significant number of women who had HSG became pregnant within the next few months. They were unsure why - speculation ran from it cleared out small blockages to it changed the ph level in some way.

My RE told me when I had my HSG 2 years ago that the reason why it makes you more fertile afterwards is because the dye makes the cilia stand up and therefore is able to grasp the egg and make it travel easier down the tube.
 Sonohysterogram / Saline Ultrasound $400-$607

What is a sonohysterogram and why is it needed?

The sonohysterogram, or saline ultrasound, is a procesdure where saline is injected into the uterus while an ultrasound is performed. It is used to look for polyps, fibroids, and other uterine abnormalities that may get in the way of fertility.

What is the difference between this sonohysterogram and a hysterosalpingogram?

The sonohysterogram is generally better tolerated than the HSG. It is not as useful for checking if tubes are patent (open), but it usually gives a better look at polyps and fibroids.

What should I expect when I have a sonohysterogram How will it feel? Will it help?

This procedure was a piece of cake. I am usually a wimp about any procedures but this one was not at all what I expected. The RE inserted a speculum (probably the worst part of the procedure!), swabbed the cervix clean, inserted a thin catheter through the cervix, removed the speculum, and inserted a transvaginal wand to use for the ultrasound.

The RE then slowly allowed saline water to move through the catheter and into the uterus so the uterus would expand. He then moved around the transvaginal wand to see the uterus and ovaries from different angles. There was some mild pressure when the saline water flowed into the uterus. I took 600 mg. of Motrin 1 hour prior to the procedure and I felt very little discomfort.

This was a very easy procedure for me - I have had an endometrial biopsy, hystersalpingogram, and 2 laparoscopies. I took one aleve before going to the radiologists office just incase I experienced cramping - they did a full pelvic ultrasound (which Ihad to drink 32oz of water prior to arriving) and a vaginal ultrasound which was to be used as a baseline for the study. After these two procedures were completed I was instructed by the radiologist as to what would happen next. A doctor came into the room he placed a speculum in vaginal area, swabbed the area with an iodine solution to prevent infection and then a very thin catheter was placed in the uterus, I experienced very mild cramping at this point,the catheter is used to dispense the saline solution, once that was in place the speculum was removed and a vaginal probe was inserted, on the other end of the catheter was a syringe filled with the saline solution, the radiologist placed the probe in position and thephysician injected the solution and the physician indicated to the radiologist the areas to mark and post so that a picture could be taken. The procedure took about 5 minutes. Once it was over I dressed and drove myself home. I experienced very light cramping for 4 days and light bleeding for the same length of time. All in all this was a very simple procedure with very light cramping at the time of the procedure, if you have had HSG or EMB you will think nothing of this and if you have not this will be the easiest test you have!

I had a SHG done in July. It wasn’t bad at all. The procedure only took about 20 minutes and I watched it on the sonogram screen. My doctor prescribed Naproxen and told me to take one an hour before the SHG and every six hours after that if I needed it. I only took one more after the procedure and only because it felt like my insides were a little sore. I had some pretty bad cramps while the were injecting my uterus with the saline. My doctor told me it is because your uterus contracts as it’s being filled up. As soon as they were through I quit cramping. I went home and took it easy for the rest of the day and I was back at work the next day. There’s really nothing to worry about and it’s over before you know it.

I felt some moderate cramping during my sonohysterogram. The radiologist was very concerned about my comfort and injected the saline slowly to minimize the cramping. I believe that helped. The test took only about 5-10 minutes. I felt fine afterward. Just a little bit of spotting.

I thought I would be having a HSG, so I was nervous & took some Ibuprofen beforehand for pain (I had heard that they are painful). But there wasn’t any pain involved in the SHG. It was uncomfortable but not a big deal. My Dr. injected the saline as the ultrasound technician did a vaginal ultrasound. When it was over, I stood up and felt a gush of liquid leak out. I went on to resume my normal activities after the SHG without a problem.

Had both this and an HSG done within one month of each other. Found this one worse b/c I was not told to take a pain killer. Not taking pain killer however allowed them to notice that my uterus was very sensitive and seemed to contract more than it should.
 Hysteroscopy - $755-$4,002

What is a hysteroscopy and why is it needed?

This is usually done under local or general anesthesia. Your cervix is dilated in order to insert a tiny scope which the doctor uses for viewing the inside of your uterus. Often carbon dioxide gas is used to expand the uterus for better viewing. Minor abnormalities may be fixed during this procedure, and it is sometimes done in conjunction with a laparoscopy, hysterosalpingogram, and/or an endometrial biopsy. Timing within the cycle varies — alone it might be done at the beginning of a cycle, with a laparoscopy it is usually done around ovulation, and with a biopsy it would be performed a few days before your period. Expect some discomfort and cramping afterward, spotting, and some shoulder pain if gas was used. It’s probably a good idea to take the rest of the day off and relax. Have some over-the-counter pain relief available or ask your physician for a prescription.

What should I expect when I have a hysteroscopy? How will it feel? Will it help?

I had this procedure, and was glad my DH was there to take me home. The procedure isn’t bad, there was some cramping afterward. Some sleep and some medication from the doctor, and I was up and running the next day.

Intercourse was painful for about 1 1/2 weeks, but fine after that! It was worth it to rule out any problems in that area.

My RE did the hysteroscopy in one of the exam rooms at the clinic. She prescribed a heavy-duty antibiotic the day before, plus ibuprofen an hour before the procedure. I had to undress from the waist down and lay on a regular exam table with my feet in stirrups, hips at the end of the table (just like a regular exam). There was an absorbent pad under my hips for the saline overflow and a paper drape over my hips for privacy.

The hysteroscope is a black wand capped by a long, thin, flexible tube, at the end of which is a tiny camera. There are two lines running from the wand — one is the feed to the TV/VCR/picture printer machine, the other runs to a bag of saline. The dr inserted a speculum and swabbed some iodine on my cervix. She then inserted the tube through my cervix and into my uterus. This caused a little bit of cramping. It only took her a minute or so to do all of this. Once the tube was in my uterus, she flooded it with saline, which expanded the uterus, and moved the tube around to take a look. The TV showed a clear color view of the uterus. She asked the nurse to record certain views and then printed out each picture to review with me later. The flooding, viewing and picture-taking process lasted about three minutes. It was quite painful due to the saline — like extremely bad menstrual cramps. I wasn’t able to watch the TV screen and ask questions as she moved the camera around because I was focused on dealing with the cramps. When she took out the hysteroscope, the saline gushed out and the cramps immediately went away. My abdomen felt a little tender for the rest of the day and I had a little bit of spotting from the saline and iodine.

I love this website and it has been very helpful to me on many occasions. I have to say, though, that my experience with a hysteroscopy this morning was VERY different from those I read about. I was prepared for a lot of discomfort/pain based on what I read.

I had no anesthesia — none at all. The doctor injected saline solution through my cervix into my uterus. It felt a little cold — and I took a nice deep breath — no pain at all. Then the doctor inserted a small flexible tube (about 5-6mm diameter) containing a fiber-optic camera into the uterus and had a look around. I saw the whole thing on video, including the openings of my tubes.

It happened so fast — it took about two to three minutes, I think.

I want other women to know it isn’t always painful — it was, in fact, completely painless. I am a big wimp about pain, so if I thought it was not bad — it was OK!

I felt a huge sense of relief and accomplishment after that.

Mine went very smoothly. Had cramping right afterward but a shot of Toradol helped that and I didn’t have to take anything after that. Recovery time was very minimal. I was back to work the next day.

I had an operative (as opposed to diagnostic) hysteroscopy under general anesthesia to remove a septum from my uterus. The procedure was done under the supervision of a laparoscopy. I had virtually no pain from the hysteroscopy only from the laparoscopy as it involves 2 small incisions in the lower abdomen.

After this I had a diagnostic hysteroscopy (not under anesthetic) and although I was given a relatively powerful painkiller before, it was still very painful (mainly on the side that I have a blocked fallopian tube, but fortunately it was over in under 5 minutes and had only mild cramping for about an hour afterwards.

(Israel)

I had a hysteroscopy back in May. I chose not to have a general anesthetic following a bad reaction to the one I had for my lap. If I had to do it again though I would have the general.

It really wasn’t too bad an experience. Whilst it is carried out you get pretty major cramps. I just found the whole experience of it something I’d rather of slept through!

Afterwards I had shoulder pains and generally felt tired. I made it to work the next day and apart from a little spotting the after effects weren’t too bad.

(Scotland)

I had a hysteroscopy in 1992, to check for possible causes of excess bleeding (basically, I had about 5 days a month where I was not bleeding, and was sick of ruining my undies!). I also had a lot of trouble with irregular cycles. Doc wanted to do an endometrial biopsy to rule out cancer (not seriously worried, but wanted to rule it out) tried do an in-office procedure, and my body would not cooperate. So the procedure would allow her to do the biopsy, clean out any abnormal growth of uterine lineing tissue which could be contributing to the bleeding, and check to see if there were polyps or other structural problems.

My hysteroscopy was performed under heavy sedation, and the doc did a D&C at the same time. It was not officially termed “general anesthesia”, though I was completely unconscious from the sedation; I suppose it could be performed with a local but from what I’ve heard about D&Cs, I would NOT recommend this!!!!

My understanding of the procedure is this: they knock you out and put you in the stirrups (I was out before they did that), use a speculum to open things up, grasp the cervix with a clamp (tenaculum) to hold it in place, inject a local anesthetic in a couple of places (paracervical block), then use a dilator to open the cervix. In my case (I read the surgical report, but may have remembered the details in the wrong order), the doc then used the hysteroscope to take a look, did the curettage to “clean things out” and see if there was evidence of abnormal uterine lining tissue, then inflated the uterus with a liquid to help visibility and reintroduced the hysteroscope. I think the whole thing took less than a half hour.

I came out of the anesthesia feeling some BAD cramping, asked for (and got) a shot of some Good Drugs (dilaudid, I think) and felt much better very quickly. Minor cramping and bleeding that day, then I felt fine the next day.

Regarding the retroverted uterus: that’s a normal finding, some large-ish percentage of women have it and it should have no impact on your fertility. I’m assuming the hysteroscopy is not in any way because of the retroversion.

I would think the main concern with dilation is that if it’s done too often, or too roughly, there would be some worry about incompetent cervix in future pregnancies. Laminaria (seaweed sticks) might be indicated to minimize this - they insert a slender bit of laminaria into the cervix the day before, which is (I gather) a bit uncomfortable; I think it absorbs fluid and gradually dilates the cervix somewhat. You could ask the doc about this.

Regarding the hysteroscopy… mine was really not fun. I’d been through a hysterosalpingogram and an endometrial biopsy and expected something along those lines. Unfortunately, this was much worse. I’m honestly not trying to scare anyone, but since I had a lot of scarring they were in there for a couple hours and I had a lot of pain and heavy bleeding afterwards. I’m normally pretty macho about pain (didn’t mind the HSG or endo biopsy and have no problem with HCG shots) but I was in bed for 2 days after this procedure.

Again, I’m not trying to be negative or scare anyone, but I had a very breezy attitude going in and was knocked for a loop after the procedure! I kind of wished someone had prepared me for the pain. The good news for me was that my previously unexplained fertility was explained as they found my tubes almost completely blocked (after HSG showed no problem). I’m now starting my first IVF (day 8 of Lupron and no problems AT ALL with that).

I also had the same experience with hysteroscopy. No problems with the other two procedures so I thought the hysteroscopy would be cake. WRONG!!! I had the procedure done on Tuesday afternoon. I was out of it until Friday and “taking it easy” as DH calls it, and still feel a little queasy (sp?) on Saturday evening. The Dr. did find a fibroid tumor and a septum of the uterus and removed them with a YAG laser. The DR left a water filled balloon in the uterus so the walls won’t heal together. This explains the extreme discomfort and nausea. So much for breezing through this procedure. Had Demerol prescription and told DH not to fill it the first day and sent him back out the next!!

On the 4th of Jan 1995 I had this operation to combat a serious disease “endometriosis”. I had laser treatment in June 1994 which unfortunately did not work. This later operation was put forward to me as being an answer to my problems, but only short term. I was informed by the specialist in England that this procedure would only keep my tubes clear for one year and my partner and I should concentrate on trying for children during this period! It is now the 5th October 1996 and I no longer have any pain when having sex yet we have been still unable to conceive a child. We attempted an IVF cycle in May of this year and managed to create 11 embryos 9 of which were acceptable. We had two replanted but unfortunately they did not take and we are going to try again at the end of the year. I f you are worried about this procedure don’t be! All I will say is that you will need love and support as you will feel pretty low and fragile but the short term effects long out weigh the long term. Remember keep healthy happy and enjoy each day as it is really a miracle that we are here in the first place!

(England)

I was very nervous about getting this test, but it wasn’t bad. I was put under anesthesia so I just woke up and it was over. I had a little cramping, felt kind of weak and achy for a couple days, which I believe had more to do with the anesthetic. The thing I didn’t like about this test was I have been having infertility and all the doctor told me from this test was that I had a big fibroid at the cavity of my uteris and he didn’t want to remove it. Then they charged my insurance company $4000 (yes, $4000) for this test and called it a surgery. I didn’t have any surgery done. My advice if you have doctors who are useless like this is to keep trying and trying until you find a good one. I’m now with a Reproductive Endocronologist whom I like. Hope this helps someone, but I was hoping to find some support in the area of infertility for people who are going through it like me.
 Laparoscopy - $1,700-$5,500

What is a laparoscopy and why is it needed?

A laparoscopy is done to look for endometriosis, adhesions and organ malformations. The patient is usually under general anesthesia for this. First, carbon dioxide gas is used to expand the abdominal cavity to provide better viewing. The doctor will then insert a scope through a small incision inside the navel or just below it to view the outside of the uterus, ovaries and fallopian tubes. Often a second incision is made just below the pubic hairline through which an instrument is inserted to gently manipulate the organs to allow the scope to examine different angles. If found, endometriosis and adhesions may be removed during this surgery. Expect some pain and cramping, some shoulder pain from the gas, perhaps some nausea from the anesthesia, and some spotting. Definitely take at least a day to relax and recover, more time if you can manage it. Ask your physician about pain relief.

What should I expect when I have a laparoscopy? How will it feel?

I am 30 yrs. old. I have had 2 Laps since I was 21.

The first was because I had been having severe pain for years during my period. I thought it could be endometriosis. The first lap apparently showed nothing, and it took 4 years to find a doctor who would do another. I was finally diagnosed with class 1 endometriosis (the least amount of adhesions, with severe pain).

I have to say that the laparoscopy was not as bad as I had thought it would be.

Perhaps if you know more about the procedure, you might not be so nervous.

After administering anesthesia, the physician will make a small incision about 1/2 inch in your navel. Then your abdomen will be filled with gas so that your organs will kind of float, giving the physician the best possible view. The laparoscope (what the doctor looks through) will be inserted through the incision.

If he should find endometriosis (as was the case with me), he may make 2 to 3 more tiny incisions near your bikini line (one on either side) to better maneuver the laser to get rid of the growths. Then the gas is released from your abdomen. And your incisions are stitched.

You will be sore, and may experience pains in your neck and shoulders for about 24-48 hours after the surgery. This is because there may be some residue gas in your body and this rises. This will go away.

You may experience bleeding for a day or two. And depending on how close your surgery was to the lap, that period may be uncomfortable and a bit heavier than usual.

Do rest as much as possible!!!!! I found that to be a big help with the second lap (since there was laser surgery involved).

I had a diagnostic laparoscopy less than a month ago to remove a very large corpus luteum cyst from my left ovary. The cyst had also bled into my pelvis, and it was uncertain whether it had killed my ovary or not (the doctor wasn’t sure if there was any ovarian torsion- the ultrasounds weren’t conclusive.)

It all happened very quickly. I went to my doctor to follow up on my ER visit, and the surgery was scheduled for that evening. I hadn’t eaten anything before my appointment, or had any pain medication since the night before, so I was told not to eat or drink anything, nor was I given anything for the considerable amount of pain I was in. I hadn’t expected to need surgery so I hadn’t had any time to prepare myself for it, other than the lengthy wait I had in pre-op (I was literally there all day waiting for the appointed time.) That, for me, was the worst part. To make matters worse, my period had started on its own that same morning(after being over a week late because of the cyst!) and I had awful cramps to go along with the pain from the cyst.

The nurse had me change into those baggy cotton pants, a hospital gown, and a robe, and gave me footies to put on (those socks with the “non slip” texture on the bottom.) When it was time to take me back, the anesthesialogist (I hope that’s spelled right LOL) asked me a lot of questions about my medical history, then told me what to expect once I got to the OR. He told me to expect a lot of activity and bright lights, and that this was normal. He also told me that I would be going under general anesthia and I wouldn’t remember a thing. He numbed the skin on my hand with some kind of shot and then put the IV in. I was taken to the OR not too long after that.

Once I got there, the last thing I remember is being moved from the bed to the operating table. Then the next thing I knew, I was saying “I hurt, I hurt, I hurt” over and over again (probably in the most pitiful voice you’ve ever heard LOL) because there was this awful sharp pain that felt like it was under my ribs and in my shoulder. I was in recovery at this time and the person with me (whether it was the anesthesialogist or a nurse or somebody else, I don’t remember) told me it was because of the gas they used and gave me something in my IV. A minute or so later, the pain was gone and I felt fine, just tired. Although even with whatever I was given, my throat still hurt horribly if I even thought about swallowing LOL I was offered some anti-nausea medication, to be given through my IV, and I accepted it. My stomach felt fine but I wasn’t sure if it would stay that way once I started moving around LOL So with the medication it continued to feel fine!

My doctor (who also was the supervising surgeon) came back and told me that the surgery went well, that my ovary was fine and the cyst had been removed and the blood cleaned out (hurray!) He also told me that everything else looked wonderful & he saw no reason why I wouldn’t be able to have “boatloads” of kids if I wanted them. My husband and I have been TTC for the past 7 months, and I started crying when I heard that, I was so happy. I was so afraid that they would find something terribly wrong with me. Of course, my doctor told me to stop crying and that he was going to go tell my DH LOL A few minutes later, I was taken out of Recovery to another room, where my husband and my parents came to see me. There was a table set up with saltine crackers and cans of cranberry juice. I was told I had to eat, drink, and urinate before they would let me leave.

So, while my parents had my painkiller prescription filled at the in-hospital pharmacy, I drank a can and a half of cranberry juice, ate a packet of saltines (although I didn’t feel like eating a thing!), and by the time they got back twenty minutes later, I urinated. Not more than 5 minutes after that, I was back in my clothes, with my husband pushing me out the door. All told, I was probably only there no more than an hour and a half after the surgery itself, which only lasted 20 minutes or so.

The next day, I didn’t have much of an appetite, but I pretty much ate what I wanted and had no problems with nausea or anything. I had started my period the morning of the surgery, so to me, there was no unusual bleeding or spotting whatsoever- it was just like a completely normal period to me. I bled the same amount, for the same length of time, and when it stopped, there was no spotting or anything. I was given both Demerol and ibuprofen for pain management, but I only took the Demerol the first two nights after the surgery (I’m a restless sleeper, and the incision at my belly button kept waking me up every time I moved in my sleep!) I took the ibuprofen for 3 or 4 days, but that was it. I got tired easily for about a week after the surgery, and that sore throat didn’t go away for about that same amount of time. A week after the surgery, I felt completely back to normal and had resumed all normal activities.

The lower incision at my hairline healed VERY quickly…it’s about 3 weeks after the laparoscopy as I type this, and you can barely see it. However, the incision at my navel still has that “scabbed over” look, although it has long since stopped hurting. For the first couple of days, there was a lot of bruising around the incisions and also on my hand where the IV had gone in. The pain in my shoulder from the gas persisted for the first couple of days but again, that was gone by the third day.

All in all, the worst part of the experience was waiting for the surgery. The best advice I could give to someone else awaiting a laparoscopy is to TAKE IT EASY after the surgery. Don’t try to overexert yourself or push yourself too hard. I wasn’t in a lot of pain or anything after the lap., but I had that “weak and tired” feeling for days afterwards, and I don’t think I would have recovered as quickly as I did if I hadn’t listened to my body and rested when I needed to. Also, invest in throat lozenges pre-laparoscopy, and have them with you! That was the worst sore throat I’ve ever had in my life, and the part I would probably dread the most if I had to go through another surgery of any kind! I had a hard time eating after the surgery, not because of my stomach, but because it hurt my throat so much to swallow!

My greatest fear going into the lap was the anesthesia. I had never had general and was very fearful about nausea and about not being able to wake up. Everyone at the hospital was very kind and understanding. The last thing I remember is the anesthesiologist saying, “You’re going to sleep now” and me thinking, “No, I’m not.” When I woke up I was very disoriented and my stomach hurt, although not too badly. They had given me 3 anti-nausea drugs in my IV before the procedure, but I still threw up every time they moved me. I was in recovery for 4 and a half hours, which I understand is long. They gave me a Compazine suppository for nausea, but it didn’t help (and I had a bad reaction). All in all, I would never want to do it again but it was bearable for one time. I would recommend that anyone having this done not be shy about sharing your fears with you doctor and with your family and friends. The thing that pulled me through was knowing so many people were thinking about me. Having friends visit and call really helped. I was knocked out for about 36 hours, semi-human for another 24, and then pretty much ok.

It gave us the answers we needed and the benefit of a videotape was tremendous. It helped my dh and I know the extent of my endo and was a great resource for my RE (she didn’t do the lap).

As far as recovery, a lot of that depends on how you react to general anesthetic. I was sick as a dog for three days, including throwing up the whole way home. But my best friend went through the Burger King drive-thru after hers.

The most important thing to remember is this–because I was sore from the gas they used to blow me up, I really favored myself when walking. In five days, I was fine except my lower back was sore. It was my own fault for tensing the muscles every time I walked. Once I realized that, I was fine in a day.

Good luck and make sure they video tape it, if possible.

I had a diagnostic Lap on May 2nd in Calgary.

1. How long did it take?

I registered in the hospital an hour before surgery. The surgery itself only took about 20 minutes, so I’m told. I wasn’t much aware of the time when I woke up from the general(early! I was still on the OR table then, which was very scary, as I had a huge tube {to keep the airway clear during surgery} in my throat and I thought I was going to suffocate. I was in a great deal of pelvic pain (worse than my worst cramps, which can be incapacitating) and they injected my IV with much more than the usual dose of morphine to try to get rid of the pain. The pain was do to the OBGYN surgeon doing a second HSG to blow my blocked tube open. I wasn’t told prior to the surgery he was going to do this. The cramps subsided about an hour after surgery to just a dull ache, and about an hour after that I was discharged, still verrrry sleepy from the morphine. My husband had to carry me from the car into our house. I was in the hospital only 4 or 5 hours in total.

2. Were you under general anesthesia or local?

General

I was laid off from my job two weeks before this, (maybe they didn’t like me going to the doctor for a couple of hours twice a week…maybe they knew what the Clomid prescriptions were for?) so I didn’t have to go back to work. We moved to Phoenix May 8, and I still couldn’t handle lifting any luggage, etc. I was a little sore in the navel area (one incision in belly-button, no stitches) for a couple of weeks after that. One thing that was very annoying, though, was that I spotted for about 4 or 5 weeks after surgery. I was told not to use baths, swim, or have sex ’til the spotting went away. Wellll, my DH didn’t like the no sex part too much, and I must admit that it was too tempting to resist sitting in the pool in 110F + weather.

I called the surgeon to follow up 6 weeks later, and he says everything looked fine with my anatomy. I don’t know where to go from here.

Hi everyone and those who are having a lap in the future, I had mine yesterday. They also did a HSG and Hysteroscopy at the same time. I went to the hospital at 10:30. They sent me to day surgery and I got changed into a johnie and a bathrobe and some slippers. I then sat with my DH in a room with a couch. They took my temp., blood pressure and weight. They moved me to a bed where lots of others are who are awaiting their surgery. They put a warm blanket on me and wanted to get my IV started. I was so nervous and clammy that my veins weren’t easy to get at so they called in the anesthesiologist. He decided to give me a shot of Novacaine in my arm that numbed me and then I couldn’t feel the IV going in at all. They gave me just saline fluids and set up my antibiotics for my mitral valve prolapse. They got me wet faceclothes and they rubbed my feet and hand. It was my first surgery so I guess I was nervous. My DH was still with me. Then my RE stopped by to say Hi. They said they would give me something to relax me and they started to wheel me down a hall. I remember the room for a minute then I must have fell asleep. The next thing I remember was awaking at 2:00 in the recovery room! I was surprisingly not nauseous! I was so happy about that! My stomach was really sore and I asked for some pain killer. My RE came by and showed me pictures. I had a polyp in my uterus, a cyst on the end of my fallopian tube, a diverticulum on my tube (an outpouching), and a fibroid tumor which was half the size of my pinky fingernail so they left that alone. I was moved to another room at 2:30 and they gave me some gingerale and toast. My throat was really sore also. They gave me a Tylenol with codeine which didn’t help much. My DH was with me again. They let me nap for an hour. Then I got up to urinate, blood was coming out also. I was wearing meshy undies with a pad. I sat up in a recliner for another 30 minutes then I got changed into a very loose sundress. You don’t want to be bending over too much. They wheeled me out to the car.

At home I was a little tired but not much. I went to bed to watch TV. I tried eating but everything tasted strange. I had to urinate on the hour almost. A little more blood came out. Not much pain from the gas at all. None in my shoulders. My stomach is still sore especially to move at all. (This is day 2) There is no way I could go anywhere at this point. I have three incisions covered by bandaids. I was able to eat some soup today. No sex for 2 weeks so I can’t get pg yet. I meet with the RE in 2 weeks for the treatment plan. I have someone with me all day today and I suggest the same, especially the first day. Yours may be easier if they only do 2 incisions. I also had no endo!

I had my Lap a couple of weeks ago. My OB/GYN performed the “Procedure” and although I too dislike hospitals, etc., it was bearable.

Make sure you follow your instructions about not eating or drinking after a certain time. My only “sin” was that I did suck on a peppermint candy a few hours before I went in. I did “confess” to the dr. though.

My tummy muscles were sore afterwards, but no real pain. Of course it depends A LOT on what they decide to do after they’re in. I just had a little scar tissue trimmed so I came out in pretty good shape.

My tummy muscles were sore for about 3 days, with each day being less sore. The worse was actually the morning after my Lap.

I went home with some prescription pain meds (Vicodan (sp?)). Took one that evening and the next day switched to Alieve. The day after that (approx 48 hrs post Lap) I wasn’t taking anything - but AGAIN it depends on your situation and what they do!

My dr. had told me that if it is a normal Lap and they don’t have to get too invasive, that if it is done on a Friday you are usually ready for work on Monday. In my case that was true.

One bummer note though - my dr. said no intercourse until my 2 week check. My dh had been going nuts - but it’s been fine with me. Maybe something in the drugs decreases your sex drive. :-)

I had a lap last summer. Most of the time was spent getting ready for the procedure, all the typical stuff they do in the hospital. I was there a total of about six hours. The actual procedure only took about an hour, and then there was recovery time. You will be given general anesthesia. Your doctor will probably tell you what you can expect after the procedure pain wise. I may not be typical but I had very little discomfort. Some shoulder pain for the remainder of the day and some abdominal pain for about a day and a half. I was back to the office in three days. Good luck. It was a procedure definitely doing in my case and I hope your’s is also a success.

I had to be checked & approved by an anesthesiologist before they put me on the waiting-list for laparoscopy. I asked about the shoulderache and she said that it was mainly caused because the nerve in the belly-area also runs through your shoulder. If there is gas left it puts pressure on the nerve, and you feel that in your shoulder. She told me it also depends a great deal on the doctor performing the operation: if he/she is really careful and makes sure that all the gas is gone you will hardly be bothered by it.

I told here that I intended to stick a box of chocolates on my belly, with a note saying “thanks for making sure all the gas is gone” ;-)

Anyway, according to the brochure they gave me (they hand out brochures before they do anything, and as the tests get more complicated the brochures get thicker….) they usually make a little cut right under the (pubic)hairline too, through which they can stick something to move your organs around to get a real good look with the “periscope” they stick through your bellybutton. Sometimes they have to move a lot, so they make a third tiny incision, but that is not the rule.

I understood from this ng that sometimes they operate on things they find (endo, blocked tubes). In my hospital they won’t do that, because there is always the possibility that it gets worse (if they make a wound it might generate scar tissue). So they will make that decision after the first lap, together with you.

You should take it easy for a few days, but ought to be ablebodied. Also, they warned me that due to the general anesthesia I might be hindered by difficult concentration and forgetfulness for a few weeks, so it was not the best time to start complicated projects at work.

(The Netherlands)

I had a Laparoscopy/Hysteroscopy/D&C all at the same time. My RE at the time had explained that I would be sore but “up and moving around by the next morning” and “back to work”. In other words, when I questioned how long I’d be out of work, he said “only the day of the surgery”. I had my surgery on a Friday morning. The surgery was completed outpatient but it took much longer than he had anticipated (several hours). I was very anemic going into surgery and had a fever. I had lost so much blood from the uncontrolled vaginal bleeding that I was very dehydrated as well. I was released from the hospital early evening (around 5pm) and discharged to home. My husband and my mother had to physically assist me from the stretcher to the wheelchair to the car….and then lift me out of the car and practically carry me up the steps to our house. I stayed in bed until the next morning. I didn’t even attempt to get up…the pain was intense. I had to be assisted by two people in order to get up from the bed to stand to go to the restroom. It hurt very bad…and walking or sitting up was intolerable. This continued for about 4 days. By Tuesday or Wednesday following my surgery I felt somewhat better and was able to get up although it still hurt and I moved very slowly. I was out of work a total for over a week total. I was bruised from one side to the other and very swollen. The gas that they use to blow you up with causes a lot of pain after the surgery as it “works” its way out of your body.

I don’t say all this to scare you. I’ve had several friends who had just a LAP and were back at work after 2 days. So, who knows? You may do just fine and be able to take that trip after all. I think a lot of my problems were because of the anemia.

I had a complication that is unusual but not unheard of (my Dr. said one of about every 200 patients will experience it). Unfortunately, no one warned me about this possibility so I didn’t realize there was a problem for quite a while. Following the surgery, I was unable to urinate. This is apparently due to either the anesthetic (general) or the catheter used during the surgery. The urinary tract goes into spasms, which you can’t feel but make it impossible to urinate. I didn’t realize there was a problem at first. I tried to use the bathroom at the hospital, unsuccessfully, but I often get sort of a “performance anxiety” at the Dr.’s office so I didn’t think much of it and figured I’d go when I got home. The nurse didn’t ask me if I had actually urinated, and didn’t mention that it would indicate a problem if I hadn’t. After being unsuccessful and increasingly uncomfortable at home, I called my Dr. He told me to go to the emergency room if things didn’t improve. I waited until the next morning, when I couldn’t stand it anymore. I went to the Dr.’s office and had to have a catheter inserted, and had that for the whole weekend (Friday morning to Monday morning). Apparently, it allows the bladder to rest so the spasms can stop. The nurse seriously scolded both my husband and me for not going to the emergency room the night before. My bladder was so full (they collected 1400 cc’s) that it was in danger of rupturing, and I nearly passed out from losing so much fluid so quickly. Monday morning I had it removed, and things were back to normal, except by Tuesday I had developed a urinary tract infection which was pretty much expected (the catheter is a great way to introduce nasties into the urinary tract).

So I thought it might be worthwhile to let others know about this potential complication, so if it occurs they’ll know to seek help sooner than I did!

A few months later [after HSG], I was in the hospital having the laporoscopy/hysteroscopy to look at my uterus and see if they could clear up the blockage on my tubes. That was not bad, especially since my RE was so nice to me before the surgery. The worst part was getting weighed in — lol :) They gave me an IV with medications and I went to sleep. Because of the extra weight and my HBP they had to intibate me (put a tube down your throat while you are asleep), which makes your throat sore for a while.

I woke up, very sick — but only because I have a real problem with anesthesia, and recovered in the day surgery room. My husband was next to me as I recovered and was very attentive to my needs, it was kind of nice to see him playing nurse for a change! Then my RE came in and said that not only did I have blocked tubes but I had a ton of scar tissue that was litterally “strangling” my uterus, that I never would have gotten pregnant that way and that he was able to clear it all out. He also confirmed our suspicions that the blockage was caused from my appendix. He said everything now looked fine and the surgery went well. I was so releived, I had to ask my DH at least a half a dozen times that my RE did say that he cleared everything out — I had to make sure I wasn’t hearing things because of the drugs!

They sent me home, once I stopped vomiting, a few hours later. Recouperation from the surgery was a bit trying for me, it’s difficult when you can’t use your stomach muscles and when you are home bound. It took me a good 3 days before I felt well enough to go out of the house, even then I probably shouldn’t have because after a few hours of shopping I felt dizzy.

All of that, and we came to find out that my DH has a low sperm count and a low mobility (he forgot to tell me about a “little” accident he had during puberity with a donkey kicking him one summer on his Uncle’s farm — ouch!) so we still have to do IVF/Blastocyst Embryo Transfer with ICSI. But, at least I know everything is fine with my uterus.

By the way, if any of you are about to undergo IVF and they mention something called a “hysterotomy” where they measure from your cervix to your uterus, don’t worry — it’s nothing worse than a pap smear. I am mentioning this because I was a nervous wreck not knowing what this test would entail. Because I was having a pap smear and vaginal cultures at the same time, I wouldn’t have even know he did it, except for the fact that he did swab the cervix with some biodine solution, so don’t be surprised to see brown spotting, and maybe bring a panty liner with you.

What are some tips for preparing for my laparoscopy?

Laparoscopy Tips

I just had my second laparoscopy this past Friday, and I’ve compiled a list of things a patient can do to make the experience a little less unpleasant, both before and after the surgery. This is based on my personal experience, some tips I’ve picked up from the newsgroups, and doctor’s orders. Any additional helpful hints and suggestions would be appreciated.

If your doctor’s orders conflict with these hints, by all means, follow what your doctor says!

Advance Planning

To minimize time missed from work, try to schedule your surgery for a Thursday or Friday so you have the weekend to recover. Clear your calendar of any major engagements for at least two weeks afterward to allow lots of relaxing and napping. Your doctor will determine what time in your cycle is appropriate for your lap, depending on its purpose, and whether other procedures (hysteroscopy, HSG, tubal ligation, etc.) are to be performed at the same time.

Engage a responsible adult(s) to drive you to and from the hospital on the day of the surgery, and to spend 24 hours with you after you return home.

Your Pre-op Appointment

Discuss with your doctor exactly what is to be done. This is the time to ask all your questions, including if and how endometriosis is to be treated, whether diseased organs are to be removed, etc. Put your wishes in writing, and be very clear! You don’t want to wake up and find that your DH has authorized a hysterectomy if you want to bear children in the future! Indicate your preference in drugs also; if you want to start trying to get pregnant immediately, you won’t want a shot of Lupron before you wake up!

Discuss all medications you are currently using, and whether they will have any effect on the anesthesia or surgery. Ask for a Rx for post-op painkillers so you can fill it in advance of surgery day.

Ask if you can get a videotape of the procedure (if you want one). This can be pretty gross or pretty fascinating depending on your viewpoint, but it really helps you to visualize and document what’s going on inside your body, and it helps if you end up changing doctors in the future.

If you think you’ll need a sleeping pill for the night before surgery, ask for one now. The doctor will prescribe something that won’t conflict with the anesthesia.

The Day Before

Eat light and healthy, and drink lots of fluids. You won’t be allowed any food or liquids after midnight, so you may want an evening snack to prevent that starved feeling in the morning, especially if your surgery is scheduled later in the day. Your doctor may ask you to do an enema in the evening to clean out your bowel. In case of more severe endometriosis, a bowel prep may be required. Follow your doctor’s instructions.

Go grocery shopping for “instant food” so you won’t need to cook for at least three days. Microwave dinners, cold cuts and bread, fruit, juices, and canned soups are all good. Avoid anything too spicy or greasy, your stomach may not tolerate it. Be sure to have saltine crackers and ginger ale in case you have nausea after the anesthetic.

Buy maxipads and panty liners; all they have in the hospital is the old-fashioned maternity pads with the belts, and you’ll probably be more comfortable with your favorite brand.

Fill your painkiller prescription and leave it in a safe place.

Rent a few videos to keep your mind occupied. Nothing too funny, though - you don’t want to be laughing the first day or so!

Clean your house - you won’t be doing that for the next few days. Put fresh sheets on your bed or sofa, wherever you think you’ll be spending time. Make sure you have two or three clean, loose-fitting outfits (no waistbands!) ready to wear when you get home.

Remove nail polish. Remove and secure jewelry and contact lenses.

Choose a soft, loose-fitting garment to wear tomorrow that’s easy to put on and take off. Wear comfortable flat shoes that slip on. Bikini or low-rise panties are better because the waistband won’t rub on your belly button after the surgery.

Pack a “hospital bag.” Include: your insurance card; a blank videotape; a pair of clean socks to keep your feet warm during the surgery; a maxipad; reading material, in case you’re stuck in pre-op for awhile; a paper lunch bag and tissues, in case you feel ill on the ride home (sorry!); a small pillow, to hug against your belly in the car; and anything else you’ll need that day.

Go to bed early and get a good night’s sleep.

Surgery Day

Wake up early and take your time bathing and dressing, so you won’t feel rushed. Don’t bother doing anything fancy with your hair-you’re only going to stuff it into a shower cap anyway! Don’t wear any makeup, cream, hair spray or deodorant.

Arrive at the hospital or surgery center at least an hour before your scheduled surgery time. You’ll need to fill out more forms and consents before you go into pre-op.

In pre-op, you’ll be offered a tranquilizer; they can add it to your IV. To minimize drug interactions, you can refuse meds at this point. It’s all personal preference. Your anesthesiologist may order something to prevent nausea. Again, it’s your choice. (Warning! Liquid Zantac is a taste sensation I never want to repeat. Think bug spray.)

When you wake up in recovery, the nurses will offer you something to help you wake up, and once again you can accept or refuse it. (I accepted it once, and the only way I can describe the sensation was like cold water pouring on my brain - NOT pleasant!) You have the option to just sleep it off.

You won’t be discharged until you have urinated, so you may be in recovery awhile. This may be difficult if you were catheterized during the surgery. When you do go into the bathroom, let the nurse help you. You may think you can walk, but your knees can turn to Jell-O without warning. If you feel nauseous, waving an alcohol pad under your nose can help.

For the ride home, recline your seat partway. Hug the pillow gently against your belly to soften road bumps. Have your paper bag and tissues nearby in case you need to vomit.

Recovery at Home

A laparoscopy usually involves two to four tiny incisions: one through the navel, where the scope is inserted, and one to three on the lower abdomen near the pubic hairline, to insert tools used to manipulate your organs. The lower abdominal incisions usually heal quickly, and they cause very little discomfort. Your navel area will be tender and swollen for a week or so; avoid clothing that may rub.

For the first 24 hours, spend as much time as possible lying down or sleeping. Lie in whatever position is most comfortable. It may help to keep your knees bent upward, so prop your legs with pillows if necessary. Use your painkillers and/or a heating pad as needed. Ask for assistance sitting up at first - those stomach muscles are very shaky right now. Keep a full glass of water with a flexible straw within reach so you won’t have get up or call for help every time you’re thirsty. Leave the TV remote control within arm’s length. Ask your DH to rub your shoulders, brush your hair, paint your toenails! Feel pampered!

You’ll probably bleed (like a period) for a couple of days, then spot for several more days.

Your pillow will become your best friend. Hugging it helps support the incisions if you prefer to lie on your side. It also helps if you cough (if you’ve been intubated), sneeze, laugh, or get the dry heaves.

The amount of surgical pain and cramping you have depends greatly on how extensive your surgery was. You may also have rib and shoulder pain from the gas used to inflate your abdomen. It will take a few days for the bloated tummy to go back to normal. The gas will also make you belch A LOT.

If you feel up to it, walk around the house a little bit. Try not to overdo it, or you may end up exhausted or lightheaded. The best way is just a little at a time.

Start with liquids and slowly work up to a normal diet, as your stomach will accept it. Room temperature foods are tolerated more easily than hot or cold foods at first. To prevent dehydration and constipation, be sure to drink lots of liquids and include some high-fiber fruits and vegetables like prunes and spinach. Chewing gum or sucking on hard candies can help control nausea.

You can usually shower the day after surgery. Have someone stay in the bathroom with you in case you need help.

If you need to be out in public, carrying a cane can be a visual clue to other people that you need special treatment. It may convince them to hold doors for you, or be less annoyed that you’re walking slowly.

Returning to Work

It’s up to you and your doctor when you return to work. If you have a sedentary job and you’re feeling well, you may be able to return within 3 or 4 days. A more physically demanding job or more complicated surgery may require longer recovery time. Your first few days back, take it easy. If you start feeling punky, leave early.

If your job requires professional attire, try to avoid pantyhose for at least a week. The waistband can be irritating on your navel. Wear long, loose dresses without waistbands and knee-highs if possible. They’ll also help conceal your bloated tummy.

The most important thing is to take it easy, and don’t push too hard. A laparoscopy is a major surgery, and it can knock your feet out from under you. Your recovery will go smoother if you take care of yourself and don’t try to rush it.

Special Thanks to Anne in Southwest Florida for this section.

The only thing I would add is to have some sore throat lozenges or Chloraseptic spray handy. I had a HORRIBLE sore throat from the intubation.

I just had my 5th lap in 6 years (for endo), and I had a pretty good experience this time. I was much less bloated and gassy, and I felt pretty good when I left the hospital. I wanted to share a few of the things that I think helped.

  1. Do a fleet enema the night before your surgery.
  2. Eat a high-fiber diet for several days before the surgery. Make your last snack before bed a bran muffin or some bran cereal. Take fiber supplement the night before as well.
  3. Ask the anesthesiologist to put anti-nausea medication in your i.v. during the surgery.
  4. Ask the nurses to put warm blankets on you before surgery and during recovery. I had a lot of trouble with violent shaking after my last lap, and the warm blankets really helped this time.

Luckily, this time my surgeon didn’t have to do a lot of heavy excision work, so that might have been part of why I feel so much better than last time (when I had endometriomas excised from my ovaries). The more they do, the worse you’ll feel — as a rule.

I hope these tips will help anyone who is going in for a lap sometime soon!

Should I expect the period after a laparoscopy to be different?

Almost two months ago I had a laparoscopy. Since no problems were found they didn’t do anything but have a good look, shuffling my organs around a bit and of course insert the gas.

I am having my second period since the operation :-(( and during both periods I have heavier cramps than I am used to. Also I have a week of cramping before my period starts. Since a lot of women seem to experience cramping during their pregnancies this got my hope up both times (30% of the unexplained get pg first 3 mos after a lap, so of course I am hoping even more than normal….] but unfortunately in vain.

Is this heavier cramping after a lap normal? Do more women experience it? Will it pass after a while? Maybe I should also mention that I had heavy, crampy periods when I was a young girl (I am 34 now) but never got those again after using bc-pills for a few years.

(The Netherlands)

My first period post lap was really late, at day 38 and the cramps were a little worse than normal but only lasting a day. Now I am awaiting my second period and it is also late, I am day 37 today. My period prelap was 27-36 days long.

I’ll add a data point. I had my lap this past May around mid-cycle. My period arrived on schedule two weeks later but was considerably heavier than usual. It also lasted about 6 days. The next cycle was also heavier than usual and lasted 5 days. The third cycle was back to normal, i.e. light flow lasting 3 days. I have PCO and probably haven’t ovulated on my own in years.

My Dr. told me to expect either a shorter or longer cycle following my lap(next Monday) but he never said whether it would last past that one cycle.

What is the difference between a laparoscopy and a laparotomy?

In total, I have had 6 laparoscopies, 1 laparotomy w/partial omentectomy, 1 laparotomy and 1 oopherectomy w/omentectomy (the oopherectomy w/omentectomy was to remove the remainder of the omenta). The laparotomy and oopherectomy AS I WAS TOLD BY MY DOCTOR involves the same type of incision as a hysterectomy (the large abdominal incision above the hair line).

The laparotomy is a large incision in the abdomen and made right above the hair line (at least in mine that is where). This type of surgery usually requires 3-5 days in the hospital and recovery period is anywhere from 4-8 weeks depending upon the person. It is rather uncomfortable for about the first week but each day truly does get a little better. I too got very sick from the anesthesia but you can request a “special something” that will reduce the chances of this happening–everyone responds differently to anesthesia so you may have no problems at all. I had morphine while I was in the hospital through an IV that I could inject a certain amount every 10 minutes but I did not use if after the first 24 hours from surgery. I found it more painful to have this drug running up my arm and through my body than the pain itself from surgery. I did request other pain pills which the doctor did give me with no problem.

The laparoscopy is definitely the route to go if you have a choice in the matter. I say this in comparing the two surgeries not on what might be best in your particular situation. The lap. is done on an outpatient basis and recovery is about 7-10 days. Incisions can vary…..I always had one right outside/inside the belly button and two above the hairline….very small incisions I might add. There are times that I had this done and felt great after 2-3 days and other times that it took a good 10 days before I felt even good. Again, it all depends upon the individual.
 Dilation & Curretage $200-$1000

What is a dilation & curettage and why is it needed?

A dilation and curettage begins with dilating the cervix to about the width of a ballpoint pen. Through the opening, an instrument shaped like a small garden hoe with a vacuum tube attached is inserted. The uterus is both scraped and vacuumed The procedure is often done in conjunction with a hysteroscopy, or to resolve a miscarriage.

What should I expect when I have a dilation & curettage? How will it feel?

I had a D&C in December 2000 because of an incomplete miscarriage. It was done at the hospital where my IF clinic is located. It was outpatient surgery and I recovered very quickly.

We had to be at the hospital two hours before the surgery. I couldn’t eat or drink anything after midnight the night before. After registering and getting a wrist band, I was brought into pre-op, where I changed into a gown (which was plenty big enough, even though I’m 265 lbs), got settled in a bed, and went through my history with the nurses. They asked about previous surgeries and any complications. A phlebotomist came in and started an IV in my forearm. A nurse started an antibiotic drip and asked me to let them know if I experienced any itching or dizziness (apparently an allergic response to the antibiotic). An anesthesia nurse came in and discussed the anesthesia with me. They also started a saline drip, which unfortunately generally has the effect of making me having to go to the bathroom a lot (which is a pain when you’re in a gown, dragging an IV pole). I was pretty emotional during all of this and the nurses were kind about it.

After a while, a transport person came and moved me (on my bed) up to the surgery waiting area. A nurse came by, checked my wrist band, and reviewed the procedure with me. Then the surgeon came by, checked my band, and reviewed everything with me again. Everyone was very careful about checking and keeping us informed. My husband was with me while I waited. Eventually, they moved me off to the operating room.

The OR was very large, cold, with a high ceiling and bright lights. I had to move from my bed to the OR bed, which was a pain what with all the blankets, the IV line (which got caught between the beds), etc. Once I was on the OR bed, everything moved very quickly. There was an anesthesia doctor, the surgeon, and two nurses. The surgeon spread my legs and placed each on a thigh rest — quite comfortable. The anesthesiologist said he would give me something to relax me. He put it in the IV and I immediately started feeling a bit woozy and sort of woolly.

Next thing I knew, I was waking up as they wheeled me out of the OR. In past surgeries, it’s taken a long time for me to wake up and lose the grogginess, but this time I was awake and aware right away. I spent about 45 minutes in recovery and was completely awake the whole time. I had a heart and blood pressure monitor hooked up — the BP monitor inflated every 10 minutes or so to check my BP. The nurse checked me frequently and also checked if I was bleeding. The surgeon had put a sanitary napkin and belt on me, which felt a little funny when I woke up.

An orderly came and wheeled the bed back up to outpatient surgery and my husband was there. The nurse gave me some juice and crackers, which stayed down fine. I’ve had trouble with nausea after anesthesia in the past, which I had told them before the surgery so they gave me some meds to counteract the nausea. I was able to get up within a few minutes and walk to the bathroom. I was a little bloody and my entire crotch (I hate that word!) had been swabbed with betadyne (an antiseptic) which was kind of sticky and disconcerting. I had no pain when I went to the bathroom. I got dressed right after that and we left. I felt OK — a little weak and tired and some minor cramps. The doctor said not to shower or bathe for 24 hours after the surgery. I stayed home from work the next day but really felt fine. I bled very lightly for about a week after the surgery.

I had my D&C 1 week ago today(on friday), the procedure went very well. I got to the hospital at 10:30AM and signed in, at 11:00AM I was taken to the outpatient presurgical waiting area. I was given a gown to change into that was generously large on me, and I weigh 285 pounds. I was then given a gurney to lay on, the anesthesiologist came to talk with me and it was decided that it would be easier on my body to just sedate me with twilight sedation. I would be awake but would have no idea what was going on. After I talked to the anesthesiologist, he put my IV in for me. I told him I was a little anxious about the procedure and he told me he would give me some Versed to calm me down a little. After putting the med in my IV, it took about 2 minutes until I was happy and feeling relaxed. At 12:30, they took me to the OR. Once in the room, they had me get myself from the gurney to the table. I remember them getting my arms on little extensions that they strapped them to and giving me a little more meds. After that I remember nothing except that I became kind of awake during the very end of the procedure, at which time they gave me a little more medication. The next thing I remember is them asking if I could transfer myself back to the gurney and I was able to do that. I was awake and alert from that point on. I went home at about 2:00, 45 minutes after the procedure ended. I was a little tired and weak and rested up over the weekend and returned to work on Monday. I spotted on and off for 5 days, but that has ended now. I was also told not to lift or strain for 1 week, and when I did I had some twinging type pains and increased bleeding. I work at a daycare center and it is kind of hard to not do any lifting. Otherwise my D&C was very easy and probably a lot easier than a lot of the procedures that we endure for infertility.

I don’t know how helpful my stories will be, but I have had 4 D and C’s in eight months and each one was different.

D and C number 1: This was the first D and C I have ever had and I was scared out of my wits. I have asthma and actually went into an attack prior to the surgery! After respiratory therapy came down to administer a treatment I was ready. The nurses were very kind, but most did not know that I had a mc. I guess the D and C procedure is pretty common. In fact, I have heard it referred to as a Dusting and Cleaning. I was given a heavy sedation instead of general anesthesia, as i tend to vomit after general. I cried as they wheeled me into the operating room. I was scared and sad. My doctor did not do much to comfort me, but the nurses did. The room was very cold and they placed warm blankets on me to warm me up. I don’t remember falling asleep. Upon waking I felt fine–a bit crampy, but only mild. I was in post-op for an hour and in my room for and hour and then drove home. The worst part was just the emotional aspect of the loss. I was told no intercourse or baths for 2 weeks. I took ibuprofen for cramps. When AF started 34 days later it was heavy and painful, not like my usual experience with AF, which had tapered off to just 3 days and light flow.

D and C number 2 was also for a mc. I went to the doctor’s office knowing that the hcg levels did not rise and the doctor “squeezed” me into his afternoon schedule. I was not as nervous and not as sad, as I had no chance to get emotional about this pregnancy. Again, I had the twilight sleep and drifted off. I even joked with the staff in the OR, saying that I would rather not rack up frequent flyer miles. Woke up, ate, went home. Two days later I was in excruciating pain and had a script for Darvocet phoned in. I was in severe pain for three days over the Thanksgiving holiday. I wondered if the doctor had scraped too hard. I never felt such abdominal pain.

D and C number 3 was again for a mc. I was 10 weeks along. This time I had been released by my RE doctor and was in my home town getting prenatal care from my OB. She was very kind and compassionate, as she had experienced the same thing twice before, the last time just weeks before this last loss. I cried and cried–I was in shock. It was pretty similar to the other two done in a large city hospital–cold room, warm blankets. Except the anesthesiologist used a general anesthesia despite my request not to and I did vomit–nasty stuff. I bled and bled–then passed large pieces of tissue for the next week and experienced a lot of pain. I called the OB’s office but I think that they chalked it up to my being emotional from the loss. Finally on day 6 I had another ultrasound which showed material left in the uterus. I had D and C number 4 one week after number three. Finally after number 4 I stopped bleeding and cramping. I know that the OB wa concerned about not scraping too hard and I think that she felt very badly for missing what turned out to be the rest of the placenta. I have had gall bladder surgery and a laproscopy, as well as a hernia repair. The D and C procedure was m