Infertility

hysteroscopy questions

sorry, kinda long.. 

My RE wants me to have a hysteroscopy before IVF #2.  So, I called today with the start of my cycle to schedule a hysteroscopy for next week.  My nurse caught me by surprise, because she wanted me to also come in for baseline testing tomorrow and start bcp this week.  I wasn't planning on this being my IVF cycle... I didn't even think that was an option, so for weeks I have been planning on getting the hysteroscopy out of the way this month, and then IVF in May or June.  Plus, my RE does not want me taking lupron this time, since I didn't have a great response with IVF #1, so I didn't think BCP would be good for me either.  When I expressed all of this to the nurse, she said I didn't have to do BCP, and I could wait until after my next period to start IVF, but it could be 4-6 weeks after the surgery before I got my period.  I also just got a bad feeling that she thought I was being stupid.  

 I was just caught off guard, because it wasn't in my plans to start IVF this month.  I always feel like I have everything figured out, and then they catch me off guard and I get overwhelmed.  So, I have a few questions:

1) Does anybody know if there is any advantage to starting IVF in the same cycle as a hysteroscopy?

2)  Was your period delayed after hysteroscopy (assuming you did not go straight into IVF)? 

 3)   How did you feel after hysteroscopy?  My nurse is advising me to take Monday (day of procedure) and Tuesday off work.  But everything I read makes it sound like there is little to no recovery time necessary.  I get stressed out about what my boss is thinking with all of these "medical procedures." 

TTC since 2008. I'm 30/DH 32. Unexplained Infertility.
All Welcome!

Unmedicated IUI: 9/11 BFN

1st IVF: January 2012. BCP, Lupron, Menopur, Gonal-F
7 eggs retrieved, 5 mature, 3 fertilized, 3dt 2 grade A embryos.
Beta 13dp3dt = 6. Beta 16dp3dt = 9. Chemical Pregnancy.

2nd IVF: Antagonist Protocol. June 2012
BCP, Ganirelix, Menopur, Gonal-F
18 eggs retrieved (6/25), 12 mature, 6 fertilized

BFP! Singleton due 3/18/13!

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Re: hysteroscopy questions

  • I have no advice on the hysteroscopy but wanted to say I understand your frustration with the nurse. I called my RE yesterday and left a message for the IVF nurse and yet the backup nurse returned my call. She tried telling me I would start BCP next week even though the RE had told me I wouldn't be taking them at all. She just didn't read my chart before calling me. So now I go in for the baseline tomorrow and hopefully will get accurate info. So...I said all that to say, if you go in for your baseline tomorrow maybe they will answer your questions before doing the ultrasound so if you don't need it you won't have to pay for it.


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  • I assume that what you are talking about is more like an endometrial biopsy than an operative hysteroscopy.  With an endometrial biopsy that is tied to an IVF cycle what they are looking to do is disturb the lining of your uterus to promote cell regeneration (make it more sticky so to speak), which as been shown to greatly aid with implantation.

    I had this done prior to IVF 3.  The procedure was completed 3 days before I stopped taking BCPs, my period arrived 5 days after the procedure, and I started stims 7 days after the procedure.

    I would think that if you waited too long to cycle following the procedure that you would miss the healing window that they are really trying to take advantage/time with ET.

    As for the procedure itself, it is definitely an uncomfortable/painful experience.  That said, I did survive it without any pain meds.  I took the rest of that day off, but was fine to go back to work the following day.

    In terms of timing, I would either cycle sooner or put off the procedure until closer to when you want to cycle.  Don't feel pressured into cycling sooner and just schedule everything according to when you feel mentally prepared to move forward.

    GL!

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  • Hmm... I have not heard anything about an endometrial biopsy.  My understanding is that they want to make sure that there is nothing going on inside my uterus that is interfering with implantation, and while they are in there they will "clean" it up by d&c, removing any polyps, etc.  I do know that I will be under "twilight" anesthesia, so I am hoping there won't be much pain.   

     But this feedback helps, as I will ask more questions when I am in tomorrow.  I just want to follow the best protocol that gives me the greatest chance for success.  

     

    TTC since 2008. I'm 30/DH 32. Unexplained Infertility.
    All Welcome!

    Unmedicated IUI: 9/11 BFN

    1st IVF: January 2012. BCP, Lupron, Menopur, Gonal-F
    7 eggs retrieved, 5 mature, 3 fertilized, 3dt 2 grade A embryos.
    Beta 13dp3dt = 6. Beta 16dp3dt = 9. Chemical Pregnancy.

    2nd IVF: Antagonist Protocol. June 2012
    BCP, Ganirelix, Menopur, Gonal-F
    18 eggs retrieved (6/25), 12 mature, 6 fertilized

    BFP! Singleton due 3/18/13!

    Photobucket
  • I had a hysteroscopy to remove a polyp that my RE noticed when I had an SHG.  I had general anesthesia.  The anesthesiologist would have given me the options, but my RE only likes to operate when her patients are completely knocked out.  I guess she doesn't want her patients moving unexpectedly during procedures. 

    AF was not delayed for me, but my RE didn't remove my lining either---just the polyp. 

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  • After hysteroscopy I felt fine and went to work the next day.  My period wasn't at all delayed.  But, I believe my RE wanted to wait until I got at least 1 period before going into my next cycle.
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    Me: 35 DH: 30 TTC since 1/2010 DX: 6/15/2011: MFI IVF with ICSI

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    IVF #2: FET 5/4/12 : Beta 5/16/12 BFN

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  • imageiguana33:

    Hmm... I have not heard anything about an endometrial biopsy.  My understanding is that they want to make sure that there is nothing going on inside my uterus that is interfering with implantation, and while they are in there they will "clean" it up by d&c, removing any polyps, etc.  I do know that I will be under "twilight" anesthesia, so I am hoping there won't be much pain.   

     But this feedback helps, as I will ask more questions when I am in tomorrow.  I just want to follow the best protocol that gives me the greatest chance for success.  

     

    If it is just a hysteroscopy then you should be fine.  The dilation of the cervix is definitely uncomfortable, but again, I didn't take any pain meds.  I fortunately was all clear so my RE just took a quick peek and then he was out.  You should be fine if they put you under twighlight sedation, but I still wouldn't go to work that day.  In terms of the timing of this procedure and your cycle - you can have this procedure  done further in advance - it doesn't need to be tied so closely to when stims begin.

    GL!

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