Yesterday, after a day filled with patients, I finally had my turn with Dr. B. I had hoped to get it done earlier in the day, sans kids, but he was busy. So of course, a few minutes into the conversation I touched Hannah's blankie and she throws an all out tantrum. He chuckles, "oh, she's throwing a tantrum!" Yes, because I touched her blankie...
"so women are temperamental even at such a young age?"
His initial "offer" and I say offer because the way it works in our relationship, is that we have an active discussion. We each share our thoughts, ask each other questions and discuss expectations. It is never a one sided conversation and decisions are made together. I have never felt I was forced into any decisions and I always feel heard and understood. So his first offer was to change my protocol. While I don't know if that's the right answer, I don't know enough to weigh in at all, so if he thinks the protocol should change, I'm ok with that.
He does not think there is anything structurally wrong which would impede implantation. He said he would have seen something significant. However, after asking around, and posting on a couple Facebook groups, I'm discovering that hysteroscopies are done routinely either before the beginning of a new IVF (so not after each individual failure, but when you start back again for another baby), or after a loss, and eventually after enough failures, but more often then not-they're done routine before beginning an IVF. I presented this as an option before moving forward. He does not think it's necessary, and he doesn't think he'll find anything. However, finding "nothing" isn't actually nothing-it eliminates one cause of a failure. To me, the more information supporting that it's just a matter of time, the better! Otherwise, I'm constantly wondering what I'm missing that I should be looking into..as more and more of my embryos slip away.
This is also why, I think, testing the embryos is ideal, especially since Dr. B keeps reminding me that 50% of my embryos are going to be bad, combined with whatever else that could have gone wrong that needed to have gone right in order to have implantation. I've heard people say they don't want to know a failure was with a normal embryo-because that makes the failure worse, thinking it must be abnormal saves you from acknowledging your personal dysfunction. I, personally, disagree. However, I told a friend yesterday, testing my embryos wasn't financially possible. I took a risk by entering treatment for this year, holding onto the belief that it wasn't worthwhile for my age. That might not have been the right decision, but there's nothing I can do about it now. I will continue to move forward.
The choice to do the hysteroscopy is mine, he said. It could be done two ways:
1) sedated-and that would have to be done in his next round of IVF, in about 1-2 weeks, because that's the only time of the month he has sedation available. And, if I want to do an April transfer, it has to be in the March IVF.
2) in-office-although painful, he believes it would be quick and less pain than someone who had never given birth. most of the pain comes from going through the cervix, but once someone has given birth, the cervix remains permanently open just a bit-enough that it eliminates the pain.
He also wants to do an endometrial biopsy-if I do the hysteroscopy, it will be done at the same time. If not, it will be done on it's own. I've had those done several times, and they're not a big deal, since going through the cervix is no longer an issue.
For now, we move forward.
Transfer #5, here we come.