I’ve heard stories about women having “increased fertility” after going through a D&C, but I never quite bought into it. Turns out it’s not a wives’ tale after all.
You may have noticed that both of the protocols I published included an “endometrial biopsy” booked 7-14 days before my listed CD 1. For the purposes of fertility, there are a couple of reasons I know of to have this procedure done.
But first, what exactly IS the procedure? Midland Fertility Clinic in the UK put together a very nice FAQ here.
That FAQ also lists the first reason: improved implantation. Some beautiful soul decided to put together a small, but well-designed trial to find out if localized damage to a patient’s uterine lining prior to undergoing IVF resulted in any significant difference in outcome of clinical pregnancies and live births achieved. There was a difference. And further studies confirmed the results. A ton of additional information can be found by Googling “endometrial biopsy (or scratch) before IVF.”
The second reason is to check uterine receptivity to implantation, and to check hormonal effects on the endometrium. The pathologist reviewing the biopsy also looks for any abnormal cells/tissue (such as cancer, polyps, or fibroids). Not a bad idea to be informed AND increase my chances of implantation.
I had that procedure done today. I took two Aleve an hour before my appointment in order to decrease discomfort. I wore comfy clothes and drove myself (though my husband met me at the RE’s office). It would have been a quick procedure had my cervix not decided to be difficult. Cervical stenosis (closing or narrowing of the cervical canal) meant I needed numbing agent injected into my cervix in order for my RE to manipulate and dilate my cervix under ultrasound guidance. The injection hurt very momentarily, and the uterine biopsy itself was not very painful either. It was more like a quick, sharp period cramp and then he was done. I’ve had very mild cramps and some light bleeding, but I was told that was to be expected. As a side note, knowing that stenosis can lower (or nix entirely) fertility by preventing movement of sperm through the cervical canal, I have to wonder how long this has been going on, and if it has indeed played an undiagnosed part in my infertility.
In any case, I also officially started my protocol yesterday. Since it was a Sunday and all of the clinics were closed, my husband took on the task of giving his first shot. Ever. Into my backside, with a 1.5″ needle. Did I mention it was his first time?
That aside, I can honestly say I was more afraid of the THOUGHT of the needle than I actually needed to be. As a former Army Medic, I have given shots (in arms and butts) many times (yeah…I can give them, but I don’t take them so well); I instructed him on the area he needed to hit (and the ones he needed to avoid). He also watched some videos of dorsogluteal intramuscular injections…some of them by RNs, some of them by women self-administering (I know of at least a couple of women who have done this with their PIO – progesterone in oil – shots). Although he was a little bit shaky and needed to draw the lines on my butt, he did a great job. I didn’t feel the needle go in, and only knew he was injecting the diphereline when he mentioned it. Then I realized I did feel a dull pressure (not pain!) in that area. He put a heating pad on the area after, and lightly massaged for a few minutes. It did get a little sore after a while, but that didn’t last the night. I also ended up with a small bruise and a temporary lump, but from what I understand neither is entirely uncommon.
All in all, not a bad couple of days, considering what we’re working for.