Tuesday, September 9, 2014

Looking for Advice

Hope everyone had a great weekend.  Ours was pretty relaxing which was a nice change.  We spent a lot of time over the weekend cuddled up on the couch and I can say the TLC did both of us good.  We found things to laugh about, other subjects to talk about (outside of infertility) and I feel like some of the sadness is starting to lift from D's eye.  Which in turns makes my heart a little lighter.  I.  Love.  That.  Man.  His happiness is everything to me.

We did have our meeting with Dr. H. on Friday.  As expected he didn't have any miracle answers or suggestions for us.  We talked about how there's still a lot that the field doesn't understand about embryo development which is why the success rate for genetically normal embryos is *only* 70%.  He feels hopeful that we still have 2 normal blasts to transfer and his recommended path is a FET.  We talked about how at our clinic (and a lot of others) their success rates are higher with FET's.  He explained that this is due to the fact that when we stim during a fresh cycle they elevate our estrogen levels way higher than they would ever be in a natural cycle.  This can cause some disruption in the two types of tissue in your uterus.  Basically the increased hormone levels affect them too.  When we do a FET he said they monitor 2 things.  1.  They want your estrogen level between 300-600.  2.  They want your lining greater than 8mm.  Obviously during stim your estrogen levels get way beyond the 600.  So basically he is feeling that doing a FET that is more in line with a natural cycle is a great option for us.

I asked him about running a couple of tests on my uterus.  I've picked the brains of several of my blogger friends and they recommended 2 types of tests.  The first is called an e-tegrity test.  My understanding is that this tests to see if your uterus has the "sticky" stuff needed for implantation.  Dr. H says the results of this test are inconclusive and due to the fact that we've had at least 2 embryos implant he doesn't think that's the issue.  The next is a hysteroscopy.  For my fertile readers this is where they go up into your uterus with a camera to look at the lining for polyps, scar tissue or fibroids that could be disrupting implantation.  Dr. H said he would perform this procedure if I felt strongly about it but he doesn't think it's necessary.  He said he's never seen any signs in all of the ultrasounds we've done that my uterus is anything but perfect.  So he basically left it up to me.

If we elect not to do the hysteroscopy we could transfer at the end of Oct.  If we do it then it will be December before we can do our FET since we have to do the procedure and I have to have another period after and my clinic doesn't cycle in Nov. to give the staff a break.

In other news we've scheduled a phone consult with Dr. Schoolcraft at CCRM for Oct. 14th.  I'll be sending him all of our records and we are completing all of the registration and history forms online.  I know that CCRM does a hysteroscopy as part of their ODW (one day workup).  I'm currently feeling like we should go ahead and have Dr. H do the hysteroscopy.  If I transfer in Oct. and it doesn't work I'll still be wondering if it is my uterus.  Of course I'm anxious to keep moving forward but I also don't want to waste the lives of 2 more embryos if my uterus is the problem.  My gut tells me it isn't and Dr. H is supporting that theory, but until we do the procedure we don't know for sure.

That being said how many of you have had this done?   What are your thoughts?  If you were in my situation would you do it or just move forward with the FET?

10 comments:

  1. I had to have a hysteroscopy per my insurance before IVF and feel like it is a good check to confirm that everything is okay. It's relatively painless and quick, so why not? I would have hated to have spent the money on a cycle only to find an abnormality later on. Just my two cents! I've also heard people claim that they do a good job of "cleaning out your pipes" and generally just ensuring there are no blockages, etc. I have NO idea if that is true. Either way, I think it is great idea to get a second opinion and there is apparently no better place than CCRM.

    ReplyDelete
  2. I definitely think you should do the hysteroscopy just in case... that way you have peace of mind. In my case, I had zero symptoms of ANYTHING and later I had a laparoscopy and they found that i had stage 3 endometriosis. It was all over my reproductive organs... not saying this will happen with you, but just saying, my dr was completely shocked by what they found because i had zero symptoms of anything for 2.5 years. They ended up doing both a laparoscopy AND hysteroscopy and our final FET was successful.

    ReplyDelete
    Replies
    1. Thanks for sharing Shay. I think it really does make sense to do it!

      Delete
  3. A hysteroscopy won't do anything about your tubes... that's a hysterosalpingogram. What it would tell you is if you had polyps, fibroids, or a uterine shape issue. I agree that it's kind of unlikely, but I would probably want one.

    Just FYI though, CCRM will probably make you repeat the test. Everyone I know had to repeat all the tests at CCRM, so if the hystersocopy isn't covered by your insurance, it may be something to think about depending on how serious you are about CCRM.

    Glad to hear you had a good weekend.

    ReplyDelete
  4. I say have the hysteroscopy done.. Sounds like you're going to need it anyway. I had two, one right after my miscarriage. They are slightly uncomfortable, but nothing to fear. Just go to your happy place. If you have it done, you can at least cross it off the list.

    Glad you had a good weekend, you deserve it!

    ReplyDelete
  5. I wish I had some advice for you but I don't :/ I'm praying that whatever you decide, will be the perfect decision. Sending you hugs! xo

    waitingforbabybird.com

    ReplyDelete
  6. Yes CCRM will have you repeat some tests and the hystercopy is one u have to do there. if you do not have insurance that they except the ODWU can get pricey. Have you looked into immune issues or possible clotting disorders. CCRM is not big on immune issues however they do check for clotting disorders and many (including myself) are put on a blood thinner to help with implantation and pregnancy in the first trimester. I am a success story from my first cycle at CCRM when I had multiple failures locally. I can't say enough good things about the practice. Will definitely be cheering you on and praying you find success soon.

    ReplyDelete
    Replies
    1. Hello! Thank you for your comment. I have had the immune test ran and it came back normal. I have not checked for clotting disorders. What does that test entail? I'm so glad to hear that you have good things to say about CCRM. I'm praying it doesn't come to that but it gives me hope to have them as an option.

      Delete
  7. I went to an Infertility conference two years ago, and one renowened REI advocated for hysteroscopy prior to the first transfer. An HSG has a 39% false negative rate for picking up cavity defects, and he commented that it had been really hard for him to have situation of multiple failures prior to doing the H-scope that found a polyp, septum, etc... A saline sonogram is just about as sensitive, but the advantage of doing an H-scope is that they can treat any defects at that time, rather than needing to coordinate another procedure.

    ReplyDelete
    Replies
    1. That was the reason that I suggested the H-scope vs. the saline is because if they do find somehting they can take care of it right then. Honestly I'm kind of hoping they find something that's fixable just to have some answers. I guess we will see.

      Delete