good news, bad news

updated at bottom

Good news: no cysts, so I begin Lupron tomorrow morning. Assuming no cysts develop, I will start stims on 3/14 with my first follicle check on 3/17. My doctor will be out of town the week I begin stims, but will absolutely be in town the two weeks after.

Bad news: He attempted the “trial transfer” today, which I wasn’t anticipating. He (it? I?) failed. He couldn’t get the catheter (and he wasn’t even using the soft Wallace catheter that is supposed to be better for ET) through my cervix to my uterus. He decided to show me more u/s pictures. He wants to attempt to dilate it again using the metal rod things during egg retrieval. If that fails, he’ll try a laminaria. If that fails? I don’t know.

I asked about success rates, and he said they wouldn’t change. But PubMed and Google disagree wholeheartedly. There are two studies that did dilation during egg retrieval. Do you know what the pregnancy rates were? Two out of 59. And one was ectopic. I’m hoping he has articles that I don’t have access to.

All the studies indicate that dilation is best done about a month before transfer. But he dilated my cervix 5 weeks before IUI #4, and that IUI was no easier (maybe harder) than the previous IUIs. So what is the solution?

I have a call in, but I’m not sure I’ll get a call back today. I’m scared. And I know I should stop worrying like this, but I’m really, really scared.

***update***
So my doctor called me back. He basically said this 1) the studies out there are old 2) he doesn’t know anything about the authors or the programs (so basically he is unimpressed) 3) we know dilation of my cervix 2-3 weeks before transfer won’t work 4) he says he has personally had better success dilating women using the metal rods vs. the laminaria 5) this happens with maybe 2-3 women per year for the whole clinic 6) that I will worry about this until it’s over and I am pregnant. Boy is he right about that.

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~ by Larisa on March 3, 2006.

7 Responses to “good news, bad news”

  1. Oh honey, first – yay for no cysts and starting the Lupron. Now, about the transfer, do you mind sharing more details? Can he not get the catheter in because it’s causing you too much pain or because he just can’t? Will having you under general anesthesia help the case at all? And I don’t blame you for being scared. This whole thing is scary enough without the added complication of the trial transfer not going so smoothly.

  2. Mellie-

    No, no pain today. He just can’t get the catheter through. He didn’t seem to think sedation would help him at all during transfer.

  3. I wish there was some kind of minor surgery he could do to get past your Fort Knox of a cervix and get things done…

    I’ll be worrying and wondering along with you…

    I’m glad your ovaries are cooperating. Lupron is supposed to keep everything nice and quiet, so don’t worry about cysts developing while you’re on the Lupron.

    Today is day 1 of Lupron — Mrs. Hope you’re on your way!!

  4. I wish there was some kind of minor surgery he could do to get past your Fort Knox of a cervix and get things done…

    I’ll be worrying and wondering along with you…

    I’m glad your ovaries are cooperating. Lupron is supposed to keep everything nice and quiet, so don’t worry about cysts developing while you’re on the Lupron.

    Today is day 1 of Lupron — Mrs. Hope you’re on your way!!

  5. Glad there are no cysts and you have started Lupron. Sorry to hear about the difficulties with the mock transfer. I understand your concerns and of course you will worry about it. We will be worrying with you. Wishing you the best.

  6. I’m so sorry about the stubborn cervix. After my first transfer from hell, my RE manually dilated my cervix under sedation during my next three transfers. I’ve seen those studies, too, and I agree that they’re not encouraging. For what it’s worth, I did get pregnant on one of those cycles, but it ended up being a chemical. Like you, dilation ahead of time would not have helped me one bit.

    At my new clinic, neither of my REs (each one has done one of my transfers there) has had nearly as much trouble with the catheter as my previous RE did. My transfers have still been done under anesthesia, but my cervix has not had to be dilated. My transfers have still been tricky but not as traumatic.

    I wish I had some real advice, but as you know, it’s a tough situation. The only thing that has seemed to help me is a change in the RE behind the catheter. I’ll be keeping my fingers crossed that come transfer day your cervix decides to cooperate. Good luck with the Lupron!

  7. Yeah – no cysts!

    As for your mock transfer, I’m sorry to hear that the doc had a hard time. In the end, they WILL figure out a way to do it.

    In the meantime, here is some assvice that may or may not help. My acupuncturist swears that if acupuncture is done 20-30 minutes before the transfer it will open up the cervix and make it easier for the transfer. To that end, when I had my mock transfer — my RE had a very hard time. Eventually she got the catheter in, but only after trying for what seemed like eternity. Then, when transfer day came, I had acupuncture done before (and after) the transfer. The RE was pleasantly surprised at how easy it was to slide the catheter through my (sharply curved) cervix.

    It may be worth a shot.

    Either way, I’ll be rooting for you.

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