Cervical Dilation Before Embryo Transfer?

LadyPavi

Hi All,

I had an egg retrieval a few months ago. While I was under, the doctor dilated by cervix because it is narrow and didn't want to cooperate during a saline sono. He wanted to make sure transfer was as easy as possible. Unfortunately, none of our embryos made it.

I just had another egg retrieval. My doctor didn't dilate me while I was out this time because he's hoping the dilation he performed last time held. But I'm going in for another saline sono before embryo transfer and he said he would dilate me again during the procedure if necessary.

Basically, I'm a big baby and really scared that it will hurt if he ends up needing to dilate me. He said he wanted to avoid it if possible because it's painful. When a gyn/RE admits that a procedure is painful as opposed to just "uncomfortable," you know that's a bad sign!

For those of you who have had your cervix dilated while awake, how much did it hurt? And what kind of pain was it? Just cramping, or burning/tearing? I'm just trying to prepare myself mentally.

00kim00

I'm not sure I have the answer to your question, and I'm also a little unsure of the situation. Are you worried about dilation for the sono or embryo transfer? If it's just the sono, I've had 2 (one regular hsg, one saline). For one, the doctor prescribed an anxiety med and told me to take ibuprofen beforehand, and it was totally fine and painless, but my husband had to drive because of the anxiety med. For the other, the doctor prescribed misoprostol to soften the cervix and told me to take 800mg ibuprofen (that one hurt- cramping and sharp pain, kinda like the worst pap smear ever and when the speculum pinches you, BUT they said it typically doesn't hurt like that, it was because they didn't get the tube in all the way, the placement was weird, and they had to try multiple times. For me, the pain was probably a 6-7 in severity, for about 20 minutes, and more burning/pinching than cramping). So if it's just the sono, you have potential options of medications to relax you (like Valium), soften the cervix (like misoprostol), and for pain/cramping (ibuprofen). But if you're doing the embryo transfer, you probably don't want to be on any of those meds. 

If it's the embryo transfer you're worried about, I know my clinic had the option of sedation. My clinic sedated for the egg retrieval (not all do), and when I went in for my ER, the woman in the bed next to me was there for an embryo transfer and was preparing to be sedated because she had so much pain when they did her ERA. The downside of that, other than the added expense, is that your partner wasn't allowed in the room if you were sedated, so he'd miss out on the embryo transfer. So for her, they were going to try without sedation, but if it was too painful, they'd kick her partner out and sedate her. I saw her after and she ended up not needing the sedation - the embryo transfer was painless. My transfer was also painless, quick, and easy compared to hsg and sono. It was mildly uncomfortable because you need to have a full bladder, and the ultrasound pushing on your bladder is the overriding sensation, just to give an idea of how mild the ET is in comparison.

So if it's the sono you're worried about, talk to the doctor about options- including valium and misoprostol and ibuprofen; sedation may even be an option if you're super worried and don't mind the expense. If it's the ET, talk to your doctor about the sedation option, but I bet the ET will be easier than you expect.

LadyPavi

Thank you! I think the idea is to dilate me mechanically (using these suckers: https://en.wikipedia.org/wiki/Hegar_dilators) during the saline sono and hope my cervix stays a little more open for the transfer a few weeks later.

They can usually get the catheter in for diagnostic tests if they use a tenaculum and a rigid catheter (ouch in its own right). My doctor just wants to avoid those things for the embryo transfer since they lowers the chance of implantation.

I'm just wondering how mechanical dilation of the cervix hurts and what it feels like.

ivfmeerut

Cervical dilation while awake can cause significant discomfort, often described as intense cramping rather than burning or tearing. Experiences vary, but preparing mentally and discussing pain management options with your doctor beforehand can help mitigate the discomfort.