Dilation

[Fredaflintstone]

So I had a mock transfer and saline investigation today. They managed to get the saline catheter through but not the mock transfer one (or any of them) which is different. So it looks like I'll need dilation. A bit annoyed that the clinic didn't explain more about when this will all happen etc following the investigation. I think it will delay things. I've read that you should wait for 1-3 months afterwards before the ET. I guess it's just a little while longer in the grand scheme of things. I wish they'd done all this in the first place. Has anyone else had dilation? Do your clinics routinely do mock transfers?

[London7]

My clinic routinely does mock transfers. I queried it and they said it was necessary to make sure there aren't issues on the day. But I didn't need dilation. Really hope it doesn't delay things for you too much - I found the waiting and uncertainty one of the hardest parts with my last cycle.

[Lizzielizzielizzie]

I had a completely failed Trial ET (having previously had a failed HSG for the same problem. Cervix too tight and completely retroverted so hard to access.

In my case, the routine trial ET at my fertility clinic was done by a specially qualified nurse, who failed, so a week later I went back and had it done by the medical director (who is also my consultant). She let me have entonox (gas and air) so I could cope as I was quite traumatized by then and also because she knew it would be long. She also used something called a 'clamp', which is as nice as it sounds, to help her to do it. She managed to get through my cervix and then drew herself a map (!) so she would know exactly how to do it next time. I then chose to have sedation for the real thing as I didn't want to gave any more memories of the procedure... twice was enough. My cycle was unsuccessful but they did successfully do ET.

Then I was already on the nhs waiting list for an exploratory laparoscopy, hysterectomy and dye test under general anyway, so my ivf clinic consultant wrote to my nhs gynaecologist to request that they did a cervical dilation at the same time as everything else whilst I was under general. The nhs consultant said my cervix was easy to get through with the hysteroscope whilst I was asleep but thankfully she performed the dilation anyway. On my second ivf cycle, the same medical director did my ET again. This time I chose not to have a trial as I already knew I would prefer to be sedated. She told me it was completely straightforward that time, she didn't have to use the clamp or anything (though I think her 'map' still helped!). If I do another round, I will consider having a trial ET again to see if I can tolerate it without sedation.

My suggestion to you would be to ask first, is there anyone senior who is willing to try a trial ET again and second, are your clinic willing to try a trial ET either with entonox or under sedation? Or even paracetamol and Valium! As I am quite sure that the stress and pain caused by the awkward location of my retroverted cervix means that I end up very tense and this makes it harder... hence why it was easy when I was under general!

I hope this is helpful, and big hugs, it's an extra stress you just don't need!!

[Lizzielizzielizzie in reply to Lizzielizzielizzie]

PS no-one told me anything about waiting for a while after dilation and I can't really see why you would need to, in fact my consultant was keen for me to do my next round of ivf within six months to be sure of having the full benefit of the dilation, as apparently it doesn't necessarily last forever.

PM me if I can be of any more help x

[Lizzielizzielizzie in reply to Lizzielizzielizzie]

Ps again, what is a saline investigation? I've never heard of it, and I've said yes to absolutely everything I've been offered!

[Lizzielizzielizzie]

**Not hysterectomy (see above)- hysteroscopy! Where they look at your womb with a camera, not remove it!!!!

[Fredaflintstone]

Thanks Lizzie and London. I'll ask about the things you've mentioned. The saline investigation or sis just shows whether the uterus expands properly and whether it shows any obvious problems. It's far cheaper than a hysteroscopy and the consultant recommended it as a first step. I had that and the mock ET done today because my fresh transfer was what they call difficult. So next step is dilation. Hopefully that will sort it but it worries me that there may be other stuff wrong (though nothing bad showed on the saline test - which involves a catheter, a balloon, saline being syringed into the uterus which helps to show the uterus more fully by ultrasound) but I'd rather not spend out for a hysteroscopy if we can avoid it because it's so costly! I think the delay will only be 1-3 months but I'm guessing a bit. I was hoping it would be in Aug. I'm not getting any younger!! Thanks for your support! Always helpful to hear other ideas and experiences xxx

London - apparently they used to always do mocks at my clinic but now don't do them routinely. Apparently I didn't meet the criteria for one at first (even tho I could have told them and I think I did tell them they my smears are always difficult to do). Ah well, we are where we are. Hopefully the dilation will do what's needed and we'll have better luck next time round. The waiting is definitely the hardest bit whatever stage we are at! Hope you are well.

Xx

[Lizzielizzielizzie in reply to Fredaflintstone]

Whereabouts are you? Why can't you have a hysteroscopy on the nhs?

[London7 in reply to Fredaflintstone]

Strange how it differs from clinic to clinic. Mine (NHS) insisted on a dummy ET because they said otherwise they could get to transfer day, find they couldn't get in there, and it could all be a disaster. Anyway, thankfully it wasn't. The doctor did have to try three different sized probes / catheters (no idea what they are called - let's call them "sticks"!) to get into mine. So there was some concern they would need to do dilation with me and I did quiz her on it while I was lying there and she was sticking these sticks in me, and what would happen if this was necessary. My memory may be faulty because, as I said, I was quizzing her in less than optimal circumstances and it wasn't necessary for me (the smallest stick was a success) so I haven't retained the information very well. But I thought she said that it would delay treatment only by about a month. But in my case it didn't happen. The SIS was routine at my clinic too.

[Fredaflintstone]

Thanks London. I wish they had done a mock and saline first at mine too. But we are where we are. That's good to know it shouldn't be too long a delay. We're fortunate to have embies in the freezer but if we didn't I'd be even more annoyed that they didn't.

Thanks Lizzie - I've not looked into it with the NHS. I could try to see if I can get a referral. Im not having any symptoms as such just this tight cervix and tilting thing but it's worth a try!

Xx

[Lizzielizzielizzie in reply to Fredaflintstone]

Like I say, consider asking your clinic whether they think they might manage it if you're under sedation too... sedation is only about £250 at my clinic x