Always assume the worst

Well I did assume the worst - that the hysteroscopy would not have solved my endometrial problems, and that's exactly what's happened.

Yesterday my dr called with the results of the endometrial biopsy and said that once again they have detected something they thought might be placental tissue and also a lot of inflammation and necrosis.

I'd been assuming the worst since things have gone so wrong this time around, and I had a gut feeling the news would be bad so it didn't hit me too hard.

The upshot is that I'm to have yet another (my third) hysteroscopy and curette to see if they can't get rid of the problems this time around. Dr D said they have to strike a fine balance between trying to get rid of all the rogue tissue and not doing any damage to my uterus.

In effect I will have had the surgical equivalent of three abortions this year, which is not great. Each one increases the chances of scarring and adhesions the more they are done. But I really have no other option. We can't put any more embryos in there until this is sorted out, and it hasn't resolved naturally after more than 12 months, so Dr D (and I) doesn't think its going to. She's asked one of her colleagues to do the surgery - not sure why, maybe he is more experienced.

I haven't got low expectations now, I've got no expectations that things will go well. It would be great to think this is the last of the surgery and it will be sorted out, but it might not be. Strangely, I don't feel as gutted about it as I might expect. I think its because we have such a slim chance of another pregnancy anyway, this is just another road block for us. If I was 10 years younger, I think it would worry me a lot more because I would be concerned about the damage to my uterus and future pregnancies.

But as it is, at best we will have only one more pregnancy, and that is extremely unlikely anyway, that it doesn't seem so devastating. Maybe it will hit me harder if it doesn't work out this time but for now, I'm just stoically plodding on and hoping for the best.

Amazing how much of a mess a badly formed placenta can make.

Just made it over the line

Today I had the endometrial biopsy as planned. AF did start to get going this morning but was very light. When I talked to the nurse, she asked was it spotting and I said, what's the definition of spotting? So she spoke to Dr D, who said we could go ahead as planned. She said she didn't want me to wait another month and this biopsy was really important before we use any more frozen embryos.

Needless to say, I was pretty glad that it was going ahead. Dealing with yet another month's delay would have really done my head in and I was feeling very down about everything last night.

The biopsy itself was very straightforward, although by the time it was done at 1.30pm, the flow was greater. Dr D made a comment about it being more than just 'spotting' so I don't think she felt it was an ideal situation but she was as keen to get it done as I was. It took just 5 minutes and I didn't even have any cramping. I've started to wonder if my cervix isn't as resistant to dilation as it was before pregnancy and so I get less cramping and pain these days.

Anyway, Dr D said this cycle was also worthwhile because we learned that my luteal phase is short and my progesterone levels are not good. She said something like 'A peak progesterone of 16 is very low'. I hadn't asked for any hormone levels this cycle, so I've got no idea what they were. It seems that while my cycles were ok when we first started out on IVF, maybe they now have changed and are not ok.

She said the progesterone levels would not have been enough to support a pregnancy and we would need to go with medicated cycles from now on. We've already done one of those after the first cancelled frozen cycle, so nothing new there. But I definitely won't be asking if we can try an unmedicated cycle as we did when Zoe was conceived.

Anyway, the results of the biopsy won't be available for two weeks, so that puts paid to another cycle until next month. I can't say I'm unhappy about that. It would have happened over christmas and new year, while we were juggling family visiting and having a few days at a beach house at new year, so its a good thing that we will be starting fresh in January.

But at least the biopsy is finally done. Now all I need is for the results to come back clear. If they don't, Dr D says we might need to try antibiotics, or even another hysteroscopy. I'm feeling so pessimistic about things at the moment that I'll be preparing myself for more bad news along those lines in two weeks.

Maybe 2011 will be our year.

More troubles?

Today I had the second blood test to confirm there wasn't a pregnancy ahead of the endometrial biospy tomorrow.

The one on Friday came back negative so I wasn't surprised that today's one did as well. Unfortunately I had started to feel hopeful about it, based on feeling some stinging at the sides of my breasts, as I did with the first pregnancy. But once again, it was negative. Don't know why I even entertained the idea it might be otherwise really. And it worries me that I was imagining phantom symptoms.

But today we've got another problem. The nurse said my progesterone levels have come right down and my period is probably not far away. I've been feeling all morning that it might be on the way and I've got some almost non-existent spotting.

The nurse said Dr D will go ahead with the biopsy tomorrow if it is just spotting. But if my period starts full-on, then its all off. I was worried this might happen all along, once I knew the biopsy was done on Day 11 after ovulation. My own experience of my cycles is that the luteal phase isn't very long but I thought I would at least make it to Day 12 so we would be ok.

Now it seems this whole cycle might have been wasted, not to mention the $335 that it has cost us. Maybe my period will hold off long enough to get the biopsy done but I'm not very hopeful.

Its just one more blow to our chances of having another baby. How much more of this can I take? I feel like I've been waiting months just for us to have another go at a frozen cycle and here we are delayed yet again.

Anyway, we won't know more until tomorrow but I know my body and my guess is that my period will be in full swing before tomorrow afternoon :-(

The long slog

I'm wondering whether I've got much more emotional energy to put into IVF. I've been feeling pretty low about it all the last few days and not having much hope we will have baby #2. I know I haven't had that hard a time of it, having only done two stim cycles, two frozens and two cancelled. Some people go through way more.

But I'm dreading another 11 day wait after a transfer, let alone multiple ones. I have to keep focussing on one day at a time and not let the long term bring me down. I'm more sure now that I want to do another stimulated cycle if our two frosties don't take. I think I have to take the approach that my body responds well to stimulation and my age might be less of a factor than it is for other women.

The statistics only tell part of the story when I look at the rates of success for the over 40's. Some women get very few eggs and don't respond well. I'm confident I will respond well again, even though it is two years later and I'm that much older.

Tomorrow I have my next blood test to make sure I did ovulate and that I'm not pregnant ahead of the endometrial biopsy next week. As much as I'd like to think positive about the pregnancy test, its just so unlikely so I'm trying not to think about it.