Hysteroscopy during IVF treatment

Ilky · September 2017

Hi all,

I haven't been on this board for a while, as I was trying to de-stress before starting the IVF cycle. So, I'm going for my DAY3 appointment tomorrow and will starts the injections the same day. My nurse gave me a call and left a voice mail saying I'll need to do a hysteroscopy either during the ER cycle or prior to frozen transfer, since my last HSG was 15 months ago. I don't get why they ask this now. I'm starting the treatment tomorrow what good can this procedure do? If they needed to see if something is preventing me getting pregnant isn't it too late now? Also, doing another invasive procedure right at this time, seems like the tipping point, as I'm already reluctant to do IVF. What do you ladies think about this? Have you done hysteroscopy during your treatment?

dragonette505 · September 2017

Hey! My doc did a hysteroscopy and a Pap smear on retrieval day! I was asleep for it all (actually at the end I sort of remember popping my head up saying: I think I'm awake! But i fell back to sleep! Lol
anyway it was no biggie for me...
i know all of this ivf stuff is stressful, but your docs are professionals and work with people like us all day everyday. It's hard, but I would try to trust them. Maybe bring up your concerns and see if they can't reassure you...

sarcasticowl · September 2017

Hi there. They often do an endometrial scratch at the same time which can help with a fresh transfer. It's also a good chance to check for polyps, which can pop up any time. It's super simple, you have no pain afterwards, and it's a way for them to make sure your uterus is as perfect as possible. Some docs do hysteroscopies before transfer no matter what. Every procedure is a little nerve wracking but it's for a good reason!

sarcasticowl · September 2017

And yes, I had a hysteroscopy right smack in the middle of prep for a frozen transfer. It was to remove a pocket of scar tissue left from a laparoscopy and it was quick and painless!

[Deleted User] · September 2017

I did two ivf cycles and next I'm waiting for hysteroscopy prior to FET, to remove a polyp. The polyp wasn't preventing me from getting pregnant, but they do want it out of there so there's a nice fresh canvas for transfer.

adirat · September 2017

Echoing PPs, I also had a hysteroscopy done. (TW) I had a very complicated recovery from d&e including retained tissue and bleeding issues so my RE wanted to check that my uterus had fully recovered before starting IVF (end TW)

While it's technically an "invasive" procedure, mine was extremely easy and quick -- I think it took five minutes total. My RE showed me the video once he was in there so I could also see that my uterus looked healthy and normal. For such a short, easy procedure, it was incredibly reassuring to me. I won't say it's comfortable to have the catheter inserted but it isn't painful at all.

That said: if you are reluctant to do IVF, then doing IVF right this month may not be right for you. May I ask why you are reluctant? Maybe the wise ladies here can offer support or help you talk it through? FWIW I was pretty scared of doing the injections for IVF but it isn't nearly as bad as I thought.

Ilky · September 2017

Thank you ladies. I went to my first appointment this morning, and they told me i wont need anesthesia so sounded like a easy and quick procedure. I will get it done next week as they said it can either be done now or during a non-transfer month. Since I want to transfer the next cycle, we'll go ahead get it done next week before ER.

As for the my hesitation, its still so hard to make peace with the whole situation, and I keep thinking why. I am so hard on myself and think my body keeps failing me, when everyone else seems like getting pregnant with a snap of their fingers. But, I know I have no other choice at this point and I have to try this before giving up. Anyhow, we started the cycle today and my first injection will be tonight.

One question, I always hear people having 20-30 follicles but doctor only saw 7 this morning. Is that all that might grow? Sounds too few...

adirat · September 2017

@Ilky What is your infertility diagnosis and age? Both of those factor into the total number of follicles you'll get. 20-30 is on the high side though...that definitely isn't standard for everyone.

dragonette505 · September 2017

@Ilky the highest ive gotten is 24 and that is very rare for someone my age....mostly I'm lucky to be getting double digits and of those only so many are mature and able to be fertilized.
As @adirat says a lot of what your docs will expect from your ovaries will depend on your age, your actual diagnosis and how those two mix. Your siggy says you are 34, which is not old, but since you are here there is some issue for you to be doing ivf. In my case (for example) I'm old. I ovulate monthly and had some fibroids removed. If I wasn't old I guess I would be trying naturally (because I ovulate monthly) but because I'm old I'm trying to bank embryos.
Its different for every girl on here, but we have some basic things in common.
my suggestion when it comes to follicle count is not to compare yourself *too much* with other people. If this is your first cycle they may be going easy on you with stims... or they may only be discussing the follicles they believe will yield mature eggs.
again, for example, last cycle I was on the antagonist protocol and I used

150 iu follistim
150 iu menopur
halfway through stims I added one pen of ganirelix (250 iu to keep me from ovulating) in the AM and another one in the PM
Then I triggered with: 500 IU HCG and Lupron (cant remember the dose)

That's pretty much down the middle...not high dose and not low dose.
Can you tell us your protocol?

cseley321 · September 2017

@Ilky I only had 9 follicles last time

Irisheyes81 · September 2017

@Ilky It's good to see you on here! I remember you from IUIs. I'm sorry you feel stressed out and like your body is failing. I battle between rage and sadness a lot too. I'm sorry you have to be here and do this.
I had a Sonohysterogram in the very beginning too. They are doing another one this week in prep for my FET. I don't know why they do those procedures but they have their reasons.
I know lots of people with less than 10 follicles from the beginning. The average that make it to freeze is three so 7 is great. Remember that it's quality over quantity. Many people (like myself) have hormonal imbalances that produce a lot of eggs but they are very low quality. Also, depending on the protocol, more can catch up. Still early.

sarcasticowl · September 2017

For me, they measured far fewer follicles than they actually got eggs. My last ultrasound before retrieval showed 16 follicles. They ended up getting 26 eggs, 19 of which were mature, 15 of which fertilized, 13 made it to day 5. So you never quite know what you're going to get just by looking at an ultrasound!

Ilky · September 2017

I'm 34 and have no known issues, but natural ways and clomid +IUI failed, so here we are. My doctor is doing the antagonist protocol (follistim, menopur and garinelex).

I'm expecting a call from nurse to tell me how much IU I need for follistim.

@Irisheyes81 nice to see you as well. Looks like you have done the retrieval and have 3 embabies. When is your transfer?

Irisheyes81 · September 2017

@llky my transfer will be in November. My clinic is the slowest of any I've seen on this forum. It's frustrating. I have all my uterine appointments this Thursday and then I'll get a for sure date. I was happy to get 3 but also started with 25. mixed emotions. How are you feeling on your protocol?

Ilky · September 2017

I just got a call from my doctor, he is canceling this cycle because I have too few follicles for my FSH level (9). I'm so bummed and in shock! I tried to so hard to get to this point and now its cancelled. I know everything happens for a reason. But, its such a news I wasn't expecting it! I was so ready to start this and have a baby!

Irisheyes81 · September 2017

@llky that completely sucks! Why does this have to be so hard????? I'm so sorry. How many days were you in? What crappy news!

adirat · September 2017

@Ilky Oh that stinks! How many days have you been stimming? Any chance you can convert to IUI?

dragonette505 · September 2017

@Ilky what?!? Wow... 9 follies sound good to me! I did a cycle where I started out with only one follie in each ovary and ended up with like 17! I've seen ppl with higher fsh too... I'm so sorry! Each doc had different parameters, but hopefully they have some ideas for moving forward!

Ilky · September 2017

I was just starting the stims. So, no medication is wasted, but the hard part is getting yourself mentally, physically, and emotionally ready and boom! it's cancelled. I heard people having less follicles and higher FSH. So, not sure. But, I'm thinking he wants to make it will work since any failed cycle will impact his success rate. And he could easily do the treatment and fail, since he would make more money. So, I think he knows what he is doing (at least that's what I tell myself:))

dragonette505 · September 2017

@ilky all we can do is trust our docs (its hard and even as I say this I'm side eyeing my doc all the time!) and there may be something he's seeing that not clear from just the few details. Did they say how many follicles they were seeing?

Ilky · September 2017

@dragonette505 he said 7. But, apparently in my previous clomid+IUI cycles there were more (11) follicles on Day3, thats why he thinks my ovaries can do better.

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