Water ultrasound/Trial Transfer Day

* In this post I will be discussing my journey with our fertility specialist. I may be going into detail of things done during the appointment, so please be aware that very little will be filtered. If you are not comfortable reading this about me, or my life, in this context please stop reading now. Also, please note, I am only discussing what I have experienced. This does not mean your journey will be the same, nor should you make any medical decisions based on what I have experienced or decide to do. I hope in some way, me sharing my journey helps you during yours. Xo

So today finally arrived and I really wouldn’t be fair to you if I tried to sugar coat it. It sucked. The whole thing, and the pain meds they recommended I take an hour prior to the appointment didn’t do anything.   Ok, let me back up a bit and start from the beginning…

I got a call from my RE’s office yesterday with results from the genetic screening of our second miscarriage. I’ll be doing a separate post on that, which you can find here (once I’ve written it). During this conversation we confirmed my appointment for today’s sonohysterogram (aka a water ultrasound)and to my surprise our trial transfer for our IVF cycle as well.  We were finally moving forward in this process and I couldn’t have been more excited!
I’m not sure the best way to discuss this afternoons appointment, so here’s a rundown in the form of bullet points. I’m going to discuss the basics for those who are here looking for information regarding their own upcoming appointment for a Sonohysterogram.

  • We arrived at the clinic and waited only a few minutes before being called back into the procedure room, where I was asked to undress from the waist down and cover myself with a blanket.  I was told the procedure would take less than 20 minutes total.  You do not need a full bladder for this, and will be asked to use the ladies room before you undress if you haven’t already.
  • The doctor and two nurses arrived only a few moments later and quickly got started. I was told that we would be doing the trial transfer first, and that is was a fairly quick procedure.
  • They have you lay down on the exam table, just like during your yearly exam, although you will be laying on an absorbent pad.  There was also one of the floor at the end of the table.
  • After using the standard forceps, the doctor cleaned the area with a special soap on a long cotton swab, which felt a little like getting a Pap smear.  Next, he inserted the catheter into my uterus.
  • Once the catheter was in place, the forceps were removed and the transvaginal ultrasound was inserted.
  • While the doctor had the catheter in place, a nurse slowly injected saline solution while the doctor took measurements and notes from the ultrasound.
  • I am not exactly sure what happened, but something went wrong and they had to do the entire process an additional two times. From my understanding, this is not normal.
  • Once the trial transfer was complete the doctor gave me a few moments to relax before starting the Sonohysterogram.
  • Once the Sonohysterogram was complete, my doctor discussed what he saw and afterwards the nurse gave me some supplies to clean up, a pad to wear home, and two heat pads to use for the cramping.
  • I was advised to take it easy the rest of the day, to not submerge myself in water for 48 hours (no baths or swimming), that light spotting is normal, and that the cramping should subside after a day or so.
  • In total, I was in the procedure room for 46 minutes.  This included the here trial transfers, the Sonohysterogram, discussing my results with the doctor and undressing/redressing.

So what did they find:

  • It seems after my two pregnancies my uterus repositioned itself and now is severely tilted. This may have been part of the trouble with the trial transfer and why it had to be done three times.
  • In the Sonohysterogram, the doctor found areas which were of concern.  While he couldn’t say for sure, but thought it could be scar tissue from my second loss.
  • As a result of the unknown areas, my next step will be a hysteroscopy. This is an outpatient procedure where a camera is inserted into the uterus so the doctor can see the lining and any problem areas.  If anything is found which needs to be removed or repaired, that procedure is done at the same time.

My thoughts, tips and little fyi’s:

  • The first trial transfer felt like really bad menstrual cramps, the second and third trials were pretty painful and the sonohystogram had tears running down my cheeks.  The forceps are as uncomfortable as they normally are during a yearly exam, but that catheter was awful. My doctor described it as being “as thick as a piece of spaghetti” and let me tell you- you feel it and it isn’t pleasant.  Throughout my research I read many women talk about this being uncomfortable but barable. I do not feel I was mentally prepared for the pain I felt at all.  Was my level of pain “normal”? Will yours be just as bad? Who knows. All I know is that by the time we got to the sonohysterogram the nurse had to remind me to breathe.
  • Here’s why: At one point, the nurse removed the catheter but neglected to deflate the balloon end. All I remember was hearing the doctor say “that wasn’t good” and then the nurse was asked to step aside while the second nurse in the room took over. No sh*t that wasn’t good! It was awful. It was at this point the doctor gave me a few minutes to rest before he reinserted the catheter for the next procedure. The good news is that I didn’t feel it this time because of the slight stretching caused by the inflated balloon being pulled out. The bad news was that the saline for the sonohysterogram was not staying inside my uterus as well as it should have.
  • When laying down, don’t have your skirt around your waist (if you wear a skirt). There is no way of knowing where the saline solution will go and the pad they have under you isn’t all that great.
  • It got hot in the room rather quickly. At first I thought it was my nerves, but when I asked to take off my shirt (I had a tank top on underneath) one of the nurses said she was fairly warm as well. I dressed in comfy layers expecting to be cold, but it was not needed.
  • I was glad to have a ride home and to have been wearing yoga pants instead of jeans. If it was warmer weather, I would have worn a maxi skirt, because the yoga pants were a bit tight around my sore midsection but it wasn’t awful.
  • Once we were given the news of needing a follow up procedure I became upset. Instead of allowing myself the opportunity to be emotional I spent several minutes trying to talk myself back into a calm state. As a result, I have no idea what the doctor was saying to me during this time.  If I could do it over, i would have asked for a moment to collect myself before talking with the RE.
  • Everyone says this, I’ve read it at least a hundred times. I still didn’t listen. Don’t get too focused on your IVF timeline. Walking into my appointment today I was expecting to start our first round with my next menstrual cycle. While the news of something being wrong was upsetting, the part I have been having the hardest time dealing with is how this will be pushing out start date back at least another month if not longer. How could I have avoided this? If I had listened to the wise words of many women before me who all said about the same thing: “Your schedule is not written in stone, it can always change- even be canceled unexpectedly.” So, if you’re like me you will probably ignore this piece of advice and already be marking the calendar of the important dates throughout your IVF cycle, but try not to. Or at the very least write them down in pencil, reminding yourself that they could all change.  This need to be my new mantra “Nothing is written in stone”.
  • Do not be afraid to ask questions. I didn’t go into this planning on being able to talk to my doctor during the procedure, but there were several opportunities when he was waiting on the nurse to do something where I was able to ask a few things.

Well ladies, there you have it.  I have read many others who have very straight forward procedures with minimal pain, and I do hope that you do not have an experience like me.

Until next time,

xo

A Heavy Heart

Buddha

My heart is heavy tonight. We have been waiting 7 weeks for results from our anora test through Natera for both of our miscarriages (we were originally told results in 1-2 weeks). One of the reasons we have been delaying our IVF start date was to see our results as our next step will be dependent on the them (to do the PGS/freeze or a fresh cycle).

I found out earlier this afternoon that one of the samples is lost. There’s no explanation yet, and we may not get one, but somewhere between the hospital, the infertility clinic and the lab in CA one of the two samples went missing. I’m at such a loss for words on this. I hate being filled with thoughts of “why me” when I know there are so many things happening in the world far greater than this, but I can’t help myself. I feel like every step of the way if there was an easy path and a challenging path, I have been led down the challenging path. I have faith that there is a reason things have been so trying, and a lesson I am to be learning, but during nights like this it is so difficult to remain positive. At this point, to have a new sample sent to the lab, it would be an additional 6-8 weeks before we get results (this incorporates the two week turnaround time the hospital needs to retrieve the slides and send them to my RE). My heart is heavy and I’m finding it hard to see the silver lining this time.

Results and a lot of waiting

* In this post I will be discussing my journey with our fertility specialist.  I may be going into detail of things done during the appointment, so please be aware that very little will be filtered. If you are not … Continue reading

A new path

* In this post I will be discussing my first appointment with my fertility specialist.  I will be going into detail of things done during the appointment, so please be aware that very little will be filtered. If you are not comfortable reading this about me, or my life, please stop reading now. Also, please note, I am only discussing what I experienced. This does not mean your appointment will be the same, nor should you make any medical decisions based on what I have experienced. I hope in some way, me sharing my journey helps you during yours. Xo

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For those who don’t know my back story, after almost a year of trying to conceive our first child I experienced two miscarriages, which happened within six months of each other. As a result of our recurrent pregnancy loss, my ob/gyn has referred me to a fertility specialist.  Today was our first appointment.  I haven’t fully digested all that happened today, but here is a rundown for anyone who may be beginning their own similar journey.

Thankfully, we arrived at our appointment early because we had a stack of forms to sign.  This was in addition to the thick packet which was filled out and already handed in. The packet mailed to us covered everything from our attempts at trying to conceive (know as ttc), both of our family’s medical history (including grandparents, aunts/uncles, cousins, etc.), our social behaviors (caffeine use, alcohol consumption, exercise, chemical we may be exposed to, questions about our sex life, our personal history, etc.), and a lot more ultra-personal information.

We were led into an exam room and my vitals were taken (blood pressure, height, weight) and we were asked some questions regarding our miscarriages. We were also asked if we wanted the tissue from our miscarriages to have genetics testing done. (We decided we would.)

Next, a one of our doctor’s residents came in and went over the packet of medical history we had previously turned in. He asked specific questions looking for further detail on some of our answers as well as reviewed our answers to make sure nothing was missed.  (Side note: our practice is part of a teaching school, so in addition to our doctor, there will often be a Resident in the room with us.)

Shortly after the interview ended, we were brought into the doctor’s office to discuss our plan, our new way of life. Being that we have gotten pregnant twice, we are not considered to have infertility. Instead, we fall under the category of Recurrent Pregnancy Loss (RTL).  We can get pregnant, we just can’t stay pregnant.   The first steps of our plan to figuring out why this happens included lots of bloodwork for the both of us, which included the Counsyl Genetic Carrier testing (I was only tested), a hcg panel (only because my most recent miscarriage was only 2 weeks ago), and other factors such as my thyroid function and a condition which causes blood clotting.

Next, I had an evaluation of my reproductive organs via a 3D transvaginal ultrasound and then the doctor and I discussed the results.  Only mildly uncomfortably, this procedure took about 15 minutes as various measurements were taken and my reproductive organs were inspected.  One of the things being ruled out was a misshaped uterus, which could lead to miscarriages.  Luckily, we learned that this is not a concern for us.

There are several tests which I could not have done yet because my body has not regulated since the most recent miscarriage. I will be tracking my hcg level via weekly bloodwork until it reaches zero. Once that happens, I will have additional bloodwork on specific days of my cycle (days 3 and again sometime between 6-12). I will also have a Sonohysterogram, which is an ultrasound used to evaluate the uterine cavity. According to my doctor, this special type of ultrasound uses fluid which is injected into the uterus, via a catheter, to view the lining in greater detail.

Due to the fact that we are able to get pregnant, my husband has had it easy so far in terms of exams.  He will not need a semen analysis and he dos not do any of the genetic screening unless it is found that I am a carrier. He did have some general bloodwork done today, but he only had three small vials drawn as compared to my 8 (3 small and 5 large vials).  He also had it fairly easy during the initial paperwork, having fewer questions to answer than I did.

Due to our recent miscarriage, it will be at least 3 months before we can start ttc again, and that length of time may be extended depending on what we find from the tests.  We will not have results from our genetic screening for 2-3 weeks and the genetic testing being done on the tissues from our miscarriages will not give us results for almost a month.

After our exams and discussions with the medical team, we met with our Financial Advisor. Luckily (unluckily) I have already hit our insurance deductible for the year so outside of a copay all the tests and bloodwork being done in the is first stage are being covered.  My husband did spend a lot of time researching what our insurance covers so there would be no surprises at this point in the day. I would highly recommend doing the same.

Here are some tips to help your first appointment go smoothly:

1) It is ok to be emotional, allow yourself to feel the various emotions you will bounce back and forth between.

2) Communicate with your husband! I spend so much of my time trying to act like I’m strong and completely ok with this that he sometimes forgets I’m one baby related commercial from completely falling apart. As a result, I then get snippy and upset with him for not realizing what I’m going through (a situation I completely created by trying to act tough!). Anyways, this whole situation can be avoided with some simple communication. I’m making more of an effort to talk to him about how I’m feeling (which seems to change often based of completely random things) and he is getting better at seeing through my “tough girl” mask.

3) Research questions to ask, as well as come up with some of your own. My hubby and I were given lots of time to ask our questions, and all of our question were answered without the feeling of being rushed.

4) Ask about support groups, most fertility specialists know of several but they do not always bring them up during the appointment unless you ask.

5) No matter how long they tell you as a time estimate for your appointment, add another hour to that.

6) Don’t be afraid to advocate for yourself. If there’s a specific test you’re interested in having done, don’t hesitate to ask about it.  Yes, they are the medical professionals but this is your body so don’t be worried to speak up. For example, my doctor wanted to wait to do all the testing and exams later when my hcg levels were at zero. I asked to do whatever tests we could today (the thought of waiting was awful to me) and he has happy to do so.

Until next time,

Xo