Looking at the female reproductive system- Inside and Outside

The HSG film at Gunasheela was read by a junior doctor.  The doctor looked at the film and told us that it was not looking good.  She then explained the problem with the picture.  Then her recommendation was to do a laparohysteroscopy.  However the process was a bit confusing.  She recommended the laparo-hyscteroscopy, but was reluctant to state it out loud the first time.  She said that the file had to be looked at by Dr. Devika Gunasheela before she is allowed to give us a recommendation.  Overall, we felt like were in a giant processing machine.  The overall advice was correct and made sense with whatever research we did, but it just felt too impersonal.

Now, having blocked tubes is quite possible.  It happens in many cases where people have some sort of abdominal infection.  Abdominal TB is a very common reason for this in India. For people with abdominal TB, treating it could restore functionality of the tubes. In our case, TB had been ruled out due to testing and medical history.

The hysterolaparoscopy was done by the doyen of infertility treatment in Bangalore, the late Dr. Sulochana Gunasheela.  I did not know that she was doing the procedure or I would have been very nervous. We got face to face with her one time and it was another assembly line process.  The poor lady looked so old... I would have not been sure of the steadiness of her hands.

Laparoscopy is a process of taking a camera and probe and looking at the abdominal cavity and the uterus and fallopian tubes and ovaries... a visual inspection if you will without making a large incision.  The make 2-3 small cuts and insert a camera/light source and a gripping device.  During laparoscopy, some fluid is pushed through the fallopian tubes to verify which tubes are working. Laparoscopy results are the "gold standard".  Sometime during hysteroscopy, the tubes could clench shut due to the "shock" and a false negative can happen.

Hysteroscopy is the process of taking a camera within the uterus and inspecting the inside walls. For good measure, they also did a DNC (Dilation and Curretage, which is just scraping off the endometrium or inner wall to allow it to grow )

What we learnt was that everything looked normal and only one tube appeared to be blocked even though it "looked" fine to visual inspection. The uterus cavity was also ruled to be normal. Endometrium was ruled "polypoid" and were told that it is not a problem.(And that is what everyone has told us so far). 

The experience with hysterolaparoscopy at Gunasheela was again not too thrilling.  We were not thrilled with the experience with the surgery... simple things such as the nursing and so on.  However, what was really disappointing was the lack of face time and proper counseling with an experienced doctor.  While the diagnosis and next steps told to us is not something we would fault (they recommended an IUI and if that does not work IVF), the fact that we got no facetime with the principals and the fact that the advice came from a couple of doctors who were junior and would not state their opinions without consulting their principals made us very reluctant to keep going there. One thing we have realized is that infertility treatment is an intensely personal process and that one should find the right clinic/doctor that works.  Trust your instincts, ask questions and gather as much information as possible.

Given that all the information pointed to a functional system, we decided to continue to try naturally for some more time.