Positive Steps Fertility Clinic

16 September 2026

Allison, you are so kind and thank you. I am so hopeful for you and this means alot to me. And we can't wait to get you over the finish line!

18 July 2026

All of you are awesome-- thank you and it has been such a privilege to help you along the way. We are so excited for you! Dr. Parry

20 March 2026

Alexis, I’m so sorry to hear you feel this way. It sounds like an incredibly long journey and I wish we could have been with you for more of it, especially since it seems like you’ve been through a lot before meeting us for testing in 2022 and then going to Dallas after based on what you’ve written. There are many ways of rethinking and reframing your journey and I’d like to do that based on what you wrote above, which will hopefully help clarify what has happened for you and what it means. I’ll be the first to agree that no test of the tubes is perfect—the tube is not a pipe but a conveyor belt. Little hairs line the tube (cilia) to push the sperm and egg together and then later push the embryo back to the uterus. Tubal patency tests are limited more to being whether a tube is open or closed and not whether the hairs work, so you can have technically open tubes that don’t work at all or barely. Ectopic pregnancies occur in tubes that are open but with damaged hairs. There are four direct tests for tubal patency: three screening tests which are x ray (HSG), ultrasound (sonosalpingography), and hysteroscopy (Parryscope), and one gold standard diagnostic test which is laparoscopy. HSG typically has sensitivity of ~50–95% and specificity of 80–90%, sonosalpingography 90–98% and 83–100%, and our 2017 JMIG publication for Parryscope was 98.3–100% and 83.7%. With no test being perfect, you try to have better sensitivity than specificity so you don’t tell a person their tube is open when it was closed and then spend money on inseminations that didn’t have a decent chance. You can even take the same test and get different results. Gleicher in the 1990’s compared high pressure HSG to low pressure. High pressure HSG may show a tube open, but sometimes this masks underlying damage. Women with high pressure patency where the tube is not open at low pressure have one quarter the pregnancy rate with insemination as those not needing high pressure. Tests are not a crystal ball, but a lens where you ask what you think you see and what you predict will happen next. I do inseminations for people all the time where tubes are closed at Parryscope testing. But many times the damage is real and even if not fully closed, we see a lower pregnancy rate. For people where we see 10–20% pregnancy rates per month with pills and insemination, if the tubes act closed we often see 1–4% per month pregnancy rates. It doesn’t mean it is impossible to get pregnant, but it does mean a much lower yield with insemination than people where the tubes were acting open with testing. Based on what you wrote above, it took time before you got to us, you got therapy along the way that didn’t work, we did testing and we were worried for your tubes, and you have gone through four embryos with two left and are still trying to conceive. The fact that you said you went another four years and are still on the path makes me worry your tubes with IUI would have given you less than the usual 1–4%, and the fact that you’ve had multiple embryo transfers without success suggests there may be more than just the tubes as an issue. I truly feel for what you’ve been through as it seems an incredibly long journey that has taken a real toll emotionally and financially. I’d be happy to do inseminations if that were the path you wanted, but if you spent $600 a month on pills, ultrasounds, and inseminations for maybe a 1% yield, statistically IVF would be a cheaper and faster path per child than trying to use the tubes. Please call us as I’d love to talk and help more. But even if you don’t, I truly hope that you get the family you want spontaneously, through inseminations or through your two remaining embryos. Respectfully, Dr. Parry