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hysteroscopy for tissue?

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  1. #1
    Jillybean
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    hysteroscopy for tissue?

    Hi everyone:

    I had a sonohysterogram today to check my uterus for any problems. Two months ago I had a D&E. The RE said everything looked good except for a large piece of tissue

    He said I did dnot have any uterine fibroids or polyps and otherwise, the uterine cavity looked good.

    Apparently, I can't proceed with my IVF cycle with that tissue hanging around. The RE told me that a hysteroscopy would remove it, or I could wait to see if my next AF gets rid of it. He felt that was sort of 50/50 chance that my body might take care of it. Otherwise, I'll have the hysterscopy.

    Is retained tissue related to Ashermans? The RE said it wouldn't hurt me (cause scars, etc), but it would interfere with implantation.

    Can you have a hysterscopy right before you start an IVF cycle, or do you have to wait another month afterwards?
    Me- 34 w/ High FSH
    DH- 33 w/ very low count and 0%-1% morphology
    Married 7 years
    IVF/ICSI is our only option

    IVF #1: 2nd trimester loss, trisomy
    Surprise BFP: chemical pregnancy
    IVF#2 RE#2: m/c, trisomy
    IVF#3: Transferred two PGS normals/ chemical pregnancy
    IVF#4: RE #3: Jan 4 2012, BFP!


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  3. #2
    Aleigh
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    *pregnancy mentioned*

    I had extra tissue after a DnC from a m/c last Sept. My doctor put me on double BC pills for 10 days to try to create a heavy period. My next period seemed just normal, but the next saline U/S looked good.

    We have been trying for a year and have had no luck. i did 4 reg cycles, 6 Follicle stim cycles and one IVF.

    I just had a hysteroscopy and she discovered an adhesion that broke right when the scope went in and she found extra tissue in 2 different places. Part of me is wondering if it was from a yer ago and didnt show up. I had one ectopic pregnancy years ago, I had a miscarriage in 07 a daughter in 08 and a m/c in Sept 09. All of those pregnancies happened first try, so we were wondering what happened. Now I'm wishing I had a hysteroscopy right after the DnC. I understand your concern though. They gave me the decision to see if AF would help or the hysteroscopy DnC, I really didnt want to go through another surgery, but now I am glad I did and I'm hoping that this does the trick!
    My RE said was doing just a light DnC and a balloon in uterus to help keep other adheasions or scarring from developing.

    Best of luck to you!!!


  4. #3
    Blondie8
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    I had retained tissue as well, quite common post pregnancy loss, especially second trimester loss. For me, I developed Asherman's after mutiple pregnancy losses, including a late second trimester loss. Retained tissue does not always mean you have Asherman's, it could be left over from the D and E. As it was explained to me, GYN's don't want to be too aggressive with tissue removal in a D and E as it can scar the uterus, sometimes tissue is left behind which will be shed with your AF. The tissue can impede implantation or cause blood flow issues to the placenta if you implant elsewhere so it's definitely not advisable to conceive before it's gone. I don't know what your Doc's policy is, mine wanted me to wait a cycle post laser treatment to remove the tissue.

    Good luck, it's good that this was picked up now as chances are your next IVF wouldn't have been succesfull.
    “Children don’t belong to us. They are litle strangers who arrive in our lives and give us the pleasure and duty of caring for them–but we don’t own them. We help them become who they are.” Gloria Steinem


  5. #4
    Jillybean
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    Aleigh & Blondie- Thank you both for responding. I feel a little better about the situation, and yes I am relieved the RE did the saline ultrasound and found the problem before the cycle.

    Aleigh-Will you need any more testing or are you done now that the hysteroscopy is finished. Did your insurance cover it, or was it billed as infertility? Did they put you to sleep? Good luck & best wishes in your fertility journey!

    Blondie- Thank you for explaining why the tissue gets left behind. I was so disturbed during my meeting with the RE, I really couldn't articulate my thoughts and questions. I am assuming the tissue is from the D&E because that was only 2 months ago.

    I was really confused when the RE was explaining it to me because I didn't realize a hysteroscopy was that invasive. I think the RE wants to wait for one more AF cycle because my cervix was lacerated in two places during the D&E and I had a large hematoma (sad and painful story). It has finally healed and I have new skin there, but it is not very thick and that it where they put the tenaculum when they are going into your cervix. I had finally gotten over what that surgeon had done to my cervix, and today I found out about the tissue. However, retained tissue is better than scarring. I really hope it comes out on its own.

    Based on what you have both told me it sounds like if I need the hysteroscopy, I will have to wait about a month afterwards before moving forward with IVF. I'll have another saline ultrasound in 4-5 weeks and if the tissue is still there I'll do the hysteroscopy.

    Thanks again
    Jill
    Me- 34 w/ High FSH
    DH- 33 w/ very low count and 0%-1% morphology
    Married 7 years
    IVF/ICSI is our only option

    IVF #1: 2nd trimester loss, trisomy
    Surprise BFP: chemical pregnancy
    IVF#2 RE#2: m/c, trisomy
    IVF#3: Transferred two PGS normals/ chemical pregnancy
    IVF#4: RE #3: Jan 4 2012, BFP!


  6. #5
    Aleigh
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    Jillybean- I always have that problem when meeting with RE. All of a sudden all this info is thrown out at you, but not being prepared with all the good questions...I always have a million questions days after the meeting. Just write them all down and call and talk to a nurse or with RE again...It's your $$ going into it all!

    There are two types of hysteroscopies...diagnostic and operative.

    I think for the diagnostic they just go in and look. For the operative , it is just that, operating on what they find. I had an operative, so I used general anesthesia. I think for diagnostic they can do it in office with out general. To be honest, I seriously do not know how it was billed, I'm waiting for that bill to come, so we'll see! More $$ More $$ urghh

    Sounds like you have a good game plan, wait a month and see if it goes away. I'm hoping it does. I would ask your Dr if your next u/s shows everything looking good, does that mean it is gone or is there things they can see with a diagnostic hysteroscopy that may not show. I am seriously wondering if that is what happened to me.


  7. #6
    Blondie8
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    Jill I totally agree that if you can avoid another intervention (and you've had more than your fair share) it would be best. I needed cerclages in both my sucessful pregnancies and anything you can do to maintain the integrity of your cervix is good. Ýou've had a rough time too, so sorry you've had such a rough go.

    I know what you mean about processing info and sorting it all out. By the time I am ready to ask good questions it's hours after the appointment and the doc is long gone.
    “Children don’t belong to us. They are litle strangers who arrive in our lives and give us the pleasure and duty of caring for them–but we don’t own them. We help them become who they are.” Gloria Steinem


  8. #7
    Jillybean
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    pg mentioned

    Aleigh- Are you cycling? How is it going? If I need the hysteroscopy, it will be operative with general anesthesia. My OB can do it and then my insurance covers 90%, or my RE can do it and my insurance pays about 1/2, which will cost me $2500.

    Blondie- Thank you for your kind words. I am hopeful that the tissue will come out on it's own, but I'm also realistic about the fact that it probably won't.

    Unfortunately I got some more disapointing news this week. After 5 years and a less than 1% chance of conceiving naturally my DH & I actually did, but it is probably a chemical preg. because the beta was really low (30). I'm really bummed because I know this is going to delay things even more. I could just kick myself, although I really never thought this would happen and I didn't think it would happen this way. I was already planning to do genetic screening with my next cycle because of my last pg. Now I am avery afraid that I will have even more problems conceiving.

    I've never had this happen before, so I don't know what to expect. Do you think they can do the saline ultrasound and/or hysteroscopy when I get AF, or do they have to wait a cycle before they can do it?

    ~Jill
    Me- 34 w/ High FSH
    DH- 33 w/ very low count and 0%-1% morphology
    Married 7 years
    IVF/ICSI is our only option

    IVF #1: 2nd trimester loss, trisomy
    Surprise BFP: chemical pregnancy
    IVF#2 RE#2: m/c, trisomy
    IVF#3: Transferred two PGS normals/ chemical pregnancy
    IVF#4: RE #3: Jan 4 2012, BFP!


  9. #8
    Aleigh
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    Jillybean- HUGSS!!!! I am so sorry!! How far along are you, is there a chance you are just at the beginning and HCG may rise? I wish I could take your pain away! There is a part of me that fear BFP, b/c that is only half my battle, I too have had a few mc's!! I am not sure about when they can do a saline u/s or hysteroscopy, I'm thinking your Dr may wait until AF? not sure...Keep us updated!! Hugs!!


  10. #9
    Jillybean
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    Pg loss mentioned

    Hi Aleigh:

    It was possible that I ovulated late; however I had a repeat beta today and it had dropped from 36 to 30, so it's definitely a chem preg. I was only 4 weeks and a few days. I have only been preg one other time and I chose d&e over labor & delivery because I was 16 weeks. Fortunately since this pg ended so early, the RE said it should just be like a heavy AF and I should get it within a week. I was relieved to hear that. Also, he said he can do the sonoysterogram and hysteroscopy after my first AF (when i lose the preg) because the pg ended so early. He thinks I'll be able to start stims at the end of Dec, which cheers me up.

    I know what you mean about bcp being only 1/2 the battle. Hopefully next time we'll both get through the other half as well

    Are you cycling right now?
    Me- 34 w/ High FSH
    DH- 33 w/ very low count and 0%-1% morphology
    Married 7 years
    IVF/ICSI is our only option

    IVF #1: 2nd trimester loss, trisomy
    Surprise BFP: chemical pregnancy
    IVF#2 RE#2: m/c, trisomy
    IVF#3: Transferred two PGS normals/ chemical pregnancy
    IVF#4: RE #3: Jan 4 2012, BFP!


  11. #10
    Aleigh
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    Hi jillybean,

    Im so sad for you, Hugs! Hopefully at this point everything goes quick so you can start you next cycle. I forgot to ask, did you concieve naturally this last time? Hugs!!

    I am currently on day 14 of Lupron( day 34 of my cycle) and no sign of AF. Urghhh I am hoping it comes today or tomorrow b/c I am travelling Fri thru tues, but our office is closed Thurs, so I dont know what will happen if I get AF while I am traveling as far as starting estrogen...


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