Sensitive - prolonged management of miscarriage - 3 attempts...

[Orangeflowers]

🤗 Hello, hope everyone is doing well.

Just a bit of a update. I had a non viable pregnancy with a empty sac as a result of a FET.

1st I thought it would pass naturally. But I still had a really strong positive 2 weeks after a 8 week scan.

So i had medical management. Still a strong positive 3 weeks later.

So I had a MVA and 3 weeks later still a positive pregnancy test, but a faint line.

I'm in Prague and had a scan yesterday in preparation for a donor egg cycle, and the Dr clearly saw retained tissue in the middle of my uterus. He said my uterus was a funny shape, I had a thick endometrium and hadn't ovulated.

He offered me a hysteroscopy to remove it on Monday but I didn't opt for that as I'd have to stay longer than expected and book a new flight and it is over 1000 euro.

I have a scan booked in with NHS gynae on Tuesday as a result of the pregnancy test. I expect they will see the retained tissue also. I'm hoping I will be offered a option to remove it.

It wasn't made clear to me but I think a D and C is more effective than a MVA which I had, and wish I'd had that now. Just didn't want unnecessary sedation. Would I be offered a D and C now if there's only a little retained product left? Do they even use ultrasound to check it's removed? I'm not sure why they don't scan after the MVA to check the materials gone right after? Maybe because everything is unsettled.

Should I have booked the hysteroscopy as this is the only effective way to make sure everything's gone?

Thoughts and experiences appreciated.

🙏 Thanks!

[Hopewhite]

hi orangeflowers I hope you’re well,I’m so sorry that you’re going through this, it’s so frustrating when the physical side drags and all you want is to move forward! I hope you have good support around you to take you through this xx I had a similar experience MMC no heartbeat at viability scan close to week 8. All in all, it took 1 month to conclude the MC, at first I tried nature to take its course for like 12 days with not a single drop of blood … then I opted for medical management (tablets) this only worked partially, I had like 16 hours of cramps, heavy bleeding passing clots ,etc and then it all stopped. Having gone through it for the first time I naively thought that was it. I had light bleeding(more like spotting) for like a couple of weeks more and still tested positive after 2 weeks and the next day I went through it all again, heavy bleeding, cramps, large clots etc ! At this point I rang the EPU and asked for my options , so they first offered a scan to make sure no retained tissue was left, but they said I could be offered more tablets or d&c depending on the scan results. Thank god that was the all clear for me , after 1 month!! My period took 2 months to come back after all that. I fully agree d&c would have been the most straightforward way to deal with it on hindsight, but after a fresh transfer I didn’t want to put my body through more. I hope this ends for you very soon, you’re a strong woman having to go through all this ! sending you love and big hug xx

[Orangeflowers in reply to Hopewhite]

Thank you so much for this. It is really helpful to know. I was so surprised the tissues still there as the clinician appeared so confident it would be rare not to work.I just don't know where I am cycle wise. I stopped bleeding a few days after the procedure, had a gap of a few days of then had what I thought was a period. I was convinced I had signs of ovulation a couple of days ago. I really do hope the cycle regulates after the D + C and hpe I get offered one.

Sorry you went through this. I hope things are on track now for your future hopes and dreams xx

[Hopewhite in reply to Orangeflowers]

I’m so sorry it’s taking so long , I hope you’re coping as well as you can with this xx I think it’s very rare but possible unfortunately. I’m not entirely sure how it works , somewhere I read that if it’s not too much tissue retained it could be discarded naturally on next period, but you definitely need a scan and proper assessment, it’s been long enough so you can ask for something better than just more waiting ! I hope your cycle regulates quicker than mine did , each body is different so hopefully you’ll be able to move forward to next steps soon!

I’m ok now thanks , this was last summer after first transfer. Wishing you all the best best of luck , hopefully you can get closure on this very soon xx

[Orangeflowers in reply to Hopewhite]

Thank you x

[PRAYINGFORTHISTOWORK]

Hi I am sorry to hear this, my daughter went through something quite similar and her body retained some, they tried on a few occasions to remove it with forceps which she said was the most painful thing ever, she ended up having a d & c but this was weeks and weeks after her loss, all in all she said she wished she had gone straight for a d & c. They didnt offer her a d & c and kept sending her away saying it will pass on its own but as it was so long she was worried about it causing an infection and then a possibility of causing other problems. In the end she insisted that they done a d & c as she was in so much pain and discomfort and also mentally she couldnt move on from the sadness as it just dragged on, as soon as she had the d & c the pain eased, i hope they will offer you a d & c if you choose to want one, as it appears to be the quickest way to help, x

[Orangeflowers in reply to PRAYINGFORTHISTOWORK]

Thank you for replying. I'm sorry your daughter went through this too. I didn't even know forceps was an option. It doesn't sound ideal. I'm sorry they tried that. I forgot that infection is a possibility. I do hope they offer me a procedure based on that xx

[Fruitandflowers]

Sorry you're going through this. I had retained products after a c-section and it wasn't picked up - I haemorrhaged and the bled heavily from around 8 weeks post partum and turned out I had a bad infection. By the time they realised what was going on and scanned me the tissue was pretty much gone and they let the small amount left shed naturally. But they put me on antibiotics and did another scan a couple of weeks later to make sure it had gone. If not they were talking about forceps - which I said I would refuse - and surgery. It did all go but it wasn't anything like a normal period and I could tell when it finally all passed. I then had a PUL last year which also started to have complications and I had urgent D&C at what would have been 10 weeks. It was very straightforward and I had no pain or bleeding, or any physical side effects really. They also scanned and did repeat HCGs a few times after to make suee it had all definitely gone. I don't know about a hysteroscopy as I had one of those as a teenager and thought it was more investigative but maybe an option. I would push for monitoring/scans, HCGs and then if it's not going, a D&C - you probably just want this all over now and the risk of infection and complications is real and gets higher if left. Also ask for antibiotics. You've been through a lot and if it helps reassure you, recovered each time very quickly once I got the treatment I needed and there was no lasting physical damage x

[Orangeflowers in reply to Fruitandflowers]

Thank you, that helps. Sometimes our bodies really don't do what we expect or want them too! Good to know what to ask for. You've been through so much. Hoping things are on track now 🙏💜x

[Fruitandflowers in reply to Orangeflowers]

I was assured over and over again how rare it was to have retained tissue after a section and told the reason I hadn't had any bleeding (at all) until that point was they'd done such a good job getting everything! I had a fresh transfer after that which was the PUL, then BFN on a FET, but less than month later I was pregnant naturally for the first time ever, in 10 years TTC, and am now 7mnths. So just advocate for what you need, don't get fobbed off or just accept things if you feel something isn't right or you're not happy with what you're being told, get through this bit, and then when you're ready and in a better place mentally and physically think about next steps x

[Orangeflowers in reply to Fruitandflowers]

That's brilliant 😀 your happy ending is coming. Thank you for giving me the information to enable me to get next steps right x

[CassieJ]

So sorry to hear you’re going through this. I had retained products after a loss. You can definitely have a D&C (much safer to be ultrasound guided) for even a small amount of tissue. And yes definitely watch for infection/talk to a doctor about antibiotics. But scaring can be an issue when D&C for retain products-not sure what the doctor meant about shape of your uterus-but if you have any history of scar tissue or issues with your uterus lining -I think perhaps an ultra sound guided hysteroscopy might be safer (not a doctor just someone who has been through scar tissue and the difficulties this can cause). Tons of luck-D&Cs normally work well just mentioning this as not sure of your history and it might be a reason your doctor suggests a hysteroscopy rather than the D&C. Xx

[Orangeflowers]

Thank you 😊 That is all really useful to know. It was my Dr in Prague that recommended the hysteroscopy. Maybe as they have that available to them but not D + C without theatre. Not sure. Hoping I can get booked in for something with NHS tomorrow x

[CassieJ in reply to Orangeflowers]

I would only think that this type of hysteroscopy should be done under general /in theatre -would really avoid doing in a doctors office. 🤞🤞it goes well with NHS tomorrow

[Orangeflowers in reply to CassieJ]

Thank you 😊

[Cinderella5]

Hey, sorry to hear what you are going through. I'm sure the NHS will check hCG and scan before next steps but it does sound like a D & C under ultrasound guidance if retained tissue seen on scan would be the way forward. I know a few others have mentioned scarring but they can be gentler knowing your wishes to conceive asap. If you get the option, have the tissue sent to pathology (if you are ok with that)....just to ensure all is well and yes antibiotics may be required. Sending hugs and a quick resolution.xx

[Orangeflowers in reply to Cinderella5]

Thank you so much 😊 I managed to have a scan today and am booked in for a MVA with ultrasound on Friday. I'm hoping that this will finally clear things. I find it a bit frustrating because a scan or treatment isn't offered without positive pregnancy test and apparently it was negative at clinic today even though retained tissue showed on the scan. I only got the scan by referring to the scan I'd had at the fertility clinic on Friday.

I'll need to test for pregnancy in 3 weeks after the mva but expect it will be negative so I'll have to sort my own scan to see 🙈 if it's finally gone x