Hysteroscopy advice

[AJKP]

I met with my consultant yesterday following my 5th ivf round and failed fet this month (3 previous miscarriages). He said that I could go for a hysteroscopy to see if I have any scarring or infections though he thinks generally my uterus seems ok, there has been no visible issues from ordinary scans so far.Is it worth doing to help with future DE transfers and what does it entail? Its quite costly on top of what we have and need to still pay so I'm just working out is it worth it or not. 🤔 xx

[JA-fnuk Partner Nurse Fertility Network UK]

Hope you get some replies from your post as this forum is an excellent source of information and support It would certainly provide lots of information about your womb and the lining - they may suggest a biopsy

Good luck for the future

Janet-Partner

[AJKP in reply to JA-fnuk]

Thank you Janet, fingers crossed 🤞 xx

[Vivkim]

I’m sorry to read about your difficult journey 💔

I had a hyseroscopy and laparoscopy to investigate recurring implantation failure and bowel pain. I have private healthcare which my clinic recommended tapping into but this is a grey area. Most private healthcare policies won’t cover fertility investigations. As I had bowel discomfort and pain following ovulation too, they agreed to cover the procedures. I played down the fertility issues with my insurer, so not to ‘muddy the water.’

The results indicated no more than what was seen on transvaginal scans in my case. They saw fibroids which I already knew about and nothing more. Nothing to explain the bowel pain either. It was reassuring to have confirmation that there was no scarring so I could take that off the table.

The procedure was straightforward. In and out in about 8 hours from start to finish. I had general anaesthetic although I understand this is not always the case for just a hysteroscopy. From the laparoscopy I have 3 small scars on my tummy. They were uncomfortable for a few days, then itchy, but I was back in work 2 days later. If you have just the hysteroscopy, I imaging you could return sooner as keyhole surgery is not needed.

I would do both again in a heartbeat, just to rule stuff out. If you’re using DE, the hysteroscopy would identify any scarring in your uterus, which transvaginal scans can’t do. A biopsy would help identify things like endometriosis. It takes about 6 weeks for biopsy results to turn around.

I should note, if issues are found, and treatment is needed e.g., removing fibroids/scarring, recovery could be a lot longer, and transferring of embryos would need to wait until you’ve properly healed (3 months I think). I agreed with my surgeon that if anything was found, he was to deal with it there and then and I was prepared to wait out the recovery time. Your other option is to have the hysteroscopy, discuss your results approx 6 weeks later, then go in a second time for treatment. This would drag the process out and be more expensive, however.

I hope this helps. If you have any questions, please shout.

Sending love and strength 💜

[AJKP in reply to Vivkim]

Hi Vivkim,Thank you so much for this info, it has been really helpful. I like the suggestion to do any treatment there and then rather than wait 6 weeks.... I hadn't realised it would take that long to get the results, so that's good to know. I'm wondering whether to do it just for peace of mind and to try and help any implantation of DE as this really is our last shot.

Thanks for taking the time to share your experiences, it's helpful for me to have more info to think about 😊 xx

[Vivkim]

No problem at all. I thought after posting my response to you, I forgot to mention the tiredness. Day 3 after the procedure it hit me like a truck. I was frustrated as I didn’t understand why (after spending over a day resting). From research, tiredness can be expected after anaesthetic. Only a small detail I know, but as I didn’t know what to expect after the op, I worried. Hopefully knowing will stop you doing the same.

I would look at it this way…if you didn’t get it done, would you ask ‘what if’ down the line? I make all my decisions based on that now.

I had a miscarriage in December. I went to work (had an Estyn inspection in school) when only light bleeding started. After several stressful days, the bleeding got worse. I now kick myself that I put myself in that situation, and ask myself ‘what if’ I hadn’t? Would the bleeding have stopped? I had a haematoma so blame myself that I caused the miscarriage because I didn’t rest when the bleeding started. Now I benchmark my decisions on ‘future me’ 🤣 Hope that makes sense 💜

If you can afford it, do it 💪🏽

[AJKP in reply to Vivkim]

I'm sorry for your loss, this is such a difficult journey isn't it. I work in quite a toxic work place so I've took a long time off work, each time I've gone back to work I've lost a baby and I'm sure the stress hasn't helped.....so just taking "me time" now as this will be my last IVF journey. I think if I have DE and miscarry without having had further tests then there is that "what if" so I think I might go for it for peace of mind, as I've not had anything else identified to explain my baby loss....they just out it down to egg quality/genetics.

Thank you for your reply 🙂 xx

[SPH12]

I’m sorry to hear your difficult journey too. These decisions can be really hard to make. Especially if you’ve had investigations before.

With my first Hysteroscopy I was told everything looked normal - although my lining was thin. But after a cancelled FET cycle, and a confusing 3D SIS where the saline balloon wouldn’t open the cavity, I was told to get another Hysteroscopy but this time under sedation. I decided to go for it (although didn’t have much hope) and I’m just recovering from it now. It worked out for us as they did find scarring - which was preferable to infection damage/estrogen insensitivity.

Bit of background: The first Hysteroscopy was done by health insurance in 2023. I was awake for the procedure and it came back normal. I found it really painful, so I wonder if my pain made them hurry the procedure. They were also quite dismissive as I had light periods and not the heavy periods/endo they were used to.

With the all clear from that Hysteroscopy we started doing IVF again. After 3 rounds we got one blastocyst. We tried to do a FET but my cycle was cancelled as my lining didn’t grow above 5.4mm with ALL the drugs possible. And there was liquid present.

So then we paid for the 3D SIS which didn’t work. Equally frustrating is that I’d already done a 3D SIS before the first Hysteroscopy in 2023 - which also came back as ‘small cavity but normal’.

Our consultant suggested a GA Hysteroscopy. It felt pretty hopeless to be honest and I almost didn’t go through with it. Especially as we had to pay ourselves to cover it this time, so it was a big decision. In the end I wanted to give it a try, just to know we’d tried everything.

It worked out as they did find scarring. They cut the scarring out both sides and I now have two coils fitted to stop the lining sticking back together…but this means I’ll need at least one more Hysteroscopy in 5-6 weeks - again at a price. And maybe even more after that. Fingers crossed it’s worth it. The rollercoaster continues at least.

So in my experience, sometimes things get missed and it’s worth getting a second opinion.

I hope this helps a little, but only you’ll know what’s right for you.

best of luck xxx

[AJKP in reply to SPH12]

Hi Sph12Thank you for your message, gosh it sounds like you have been through a lot regarding your scans and tests!! Im thinking more that it might be worth it as there might be some scarring that no one has detected before and it might give me peace of mind!!

I hope all goes well with your next procedures, its such a gruelling and expensive journey!! Xx