Moving Forward

After finding out that our first IVF cycle had failed I did not really start to feel better until after I talked to my doctor to figure out what we could do next (and how soon we could do it). I felt a little lost and defeated all weekend. First thing Monday morning I called the clinic and scheduled an appointment to meet with our doctor for a consultation. The soonest they could get me in was Wednesday afternoon. Not long after I scheduled the appointment Ryan called from work and said that Dr. Moore had actually left him a message on his cell phone offering his sympathies and saying that he could just talk to us on the phone about what to do next. He said to send him an email letting him know a good time when he could talk to both of us. So I cancelled my appointment and emailed my doctor to schedule a phone call instead.

That afternoon I got a fun surprise. My sister-in-law stopped by with our two nephews to see how I was doing and tell me they were sorry that IVF hadn't worked this time around. The youngest nephew was feeling sick and waiting in the car, so they couldn't stay long but they brought me cookies and a coloring book. She had taken the kids to Target and told them to pick something out for me. They had chosen a coloring book and crayons because I was probably sitting in bed and they thought that would give me something to do. It was so sweet of them all to come by! I have colored in that coloring book with my nieces nearly every time they have come to visit since then, so it has turned out to be a fun gift and I think of my sister-in-law and her kids every time I see it. She finished the visit with a hug from her and another from my mother-in-law (who lives about four hours away and could not be there herself).

That night after Ryan got home from work we called Dr. Moore on his cell phone and talked to him for about thirty minutes. He said that they really don't know why it doesn't work sometimes. He also said that often frozen embryo transfers have better success rates than fresh transfers. The first thing I had to do was start taking birth control pills again. Since I had already started my period over the weekend, I would start the pills the following day. In 2-3 weeks he wanted me to come in for an endometrial biopsy. He explained that endometrial biopsies were used to improve the chance of the embryo implanting when they timed it about 4 weeks before an embryo transfer. They only did the procedure on women who had previously had an unsuccessful transfer with a good quality embryo. All of this meant that we would be able to try again in about 6-7 weeks. That was not as soon as I had hoped, but it still was a relief to have a new plan in place. It gave me something to focus on and look forward to. Those who know me know that I plan ahead for EVERYTHING!

A few days later one of the nurses emailed me and said that Dr. Moore would like me to have a sonohysterogram before we did the endometrial biopsy just to make sure the polyp I had removed previously had not grown back. As it turned out I was able to do both at the same appointment so I scheduled it for March 28, 2014.

Our appointment brought another surprise. Watching the doctor do the sonohysterogram (to learn what that feels like, read about my first one here) I could tell something was wrong: he had such a serious look on his face as he looked studiously at the ultrasound and he kept having the nurse inject more fluid. It seemed to last forever (which is bad because it hurts). After he was done he told Ryan and I that he had seen something on the ultrasound that he suspected was scar tissue from the polypectomy I had in November by the way it moved when the fluid moved past it. He showed us a picture on the screen and it just looked like little bands of thin tissue. He said there was a possibility it was just some endometrial tissue not scar tissue, but the only way to tell was with another hysteroscopy to get a better look and then remove whatever it was.

They did not check for scar tissue before our first IVF cycle because it is so rare (it only happens in 5% of cases) so it is not usually a concern. After removing the scar tissue they would leave a small balloon inflated in my uterus for about a week (which sounded awful to me) to keep the sides from touching each other and more scar tissue from forming. The bad news was because of the time needed to heal, our second IVF cycle would likely be delayed for about two more months (which meant late June). That was the part that was most upsetting to me. We left the doctor's office very disappointed. It seemed like it was one thing after another! I felt like I should be relieved that maybe we knew why the first embryo transfer did not work, but instead I was upset that we had not checked sooner so we could've had this taken care of before.

We went in for my hysteroscopy on April 3. This one was much easier than the first one. It was a smaller area they had to cut into so it was done as an in-office procedure under conscious sedation (like I had for the egg retrieval) rather than under full anesthesia in a hospital like my first hysteroscopy. After the procedure we found out that the bands of what looked like scar tissue were actually just what the doctor called "wispy polyps" that they had been able to easily snip off. The doctor who did the procedure said that they were not something that would've interfered with implantation our first time around and that I would heal quickly so we could start preparing for our frozen embryo transfer in a couple of weeks.

That was good news and bad news. I felt good knowing that there was nothing we could've done to potentially change the outcome of our first embryo transfer, but it was also worrisome because now we again had no idea why it didn't work so we had no assurance to make us think the second try would be more successful. Overall I was still grateful that we had done the procedure because I felt like we were doing everything possible to make my uterus a welcoming home to a growing embryo and help the process to be a success. One good thing about procedures like this is that you go home feeling a little groggy...sometimes you need a day to turn your mind off and just sleep to get you bearings back.

The recovery this time around was also easier than the previous hysteroscopy. I stayed down the day of the procedure and felt a little crampy after. The next day I felt almost completely normal. When the nurses called to get us on the schedule we discussed dates and I found out that to have Dr. Moore do the transfer we would have to wait about three extra weeks. We decided we wanted to do our next embryo transfer as soon as possible even if it meant that one of the other doctors would do the actual procedure. She emailed me a new calendar and we began planning for our first frozen embryo transfer that would take place the week of May 26. I was already on birth control so the first step would be starting back on Lupron injections on April 27, then an endometrial biopsy the week of April 28 (read about my experience with that here).

My new (and current) calendar.