Dr. Surrey called the evening of my second beta to offer his condolences on my biochemical pregnancy. He said that most likely either (1) the embryo had a chromosomal problem that the current testing cannot pickup or (2) there's an issue with my lining that they can't observe. He actually brought up the word "surrogate" although he feels it's too soon to consider that route. I think he was starting to prepare me just in case. My impression was that he was pretty shocked at this outcome given the quality of the embryo & how beautifully it thawed. I reminded him that the tissue from the one D&C I had came back as 46XX. I've never been 100% convinced that was my tissue and it has bothered me even before this latest loss with a known (assuming no testing error) chromosomally normal embryo. Basically, Dr. Surrey said the last rock to look under is an endometrial biopsy to check for the beta integrin protein, which I plan to do this next cycle. Investigating lining issues is new to me so I'd really appreciate any and all advice and information. I've had the recurrent pregnancy loss panel (although I intend to ask Dr. Surrey if we should repeat it as a precaution since that was two losses ago). Is there any other testing that I should request?
At one time I recall reading a discussion about endometrial scraping, the idea being that damaging the uterine lining somehow produced a reaction that later aided implantation. Will the biopsy achieve this if I do a transfer within a few months?
The other thing I want to discuss with Dr. Surrey is my lining thickness. I did my ultrasound a day earlier than normal and it was already at 13.7mm. I read on one site that a lining that's too thick can actually hurt implantation so I want to see if we can aim for a slightly thinner lining next time. That may be tricky though because I seem to always have trouble with my Estrogen being stubbornly low both on stim and transfer cycles.
Thank you for all of the comforting words this week. They all made me feel much less alone. I tried going to work on Wednesday and finally ended up telling my new boss the situation because I wasn't doing well at work. He & his wife recently adopted after a long struggle with infertility & then two failed adoption placements so I knew he'd be sympathetic. He actually thought I was going to quit when I called him from a conference room (he's based out west). He offered to give me more time off, but I said that work was a good distraction for me, but I'd do better at home so he's letting me work from home this week. My mom is staying with me so between her & my dogs I'm holding it together. I hate bedtime & first thing in the morning as that's when it all really hits me. I just wish I knew what to do next.
T.
I had both the endo biopsy and the scraping done with my last transfer. I am glad I did it, and would do it again if we ever did another transfer. The treatment for the endo biopsy is two months of dep.ot lup.ron. I know some REs will have you do the treatment without the biospy, too. The "scraping" is really just an endo biopsy where they throw away the tissue they remove. It can be done by any gyn or RE.
ReplyDeleteHope that helps, T. Big hugs to you my friend.
I did the back to back biopsies to injure the lining prior to the transfer where I got my one and only ever positive--though it was a painfully low chemical pregnancy only. My gyn did it and just tossed out the tissue, like Patience said.
ReplyDeleteI also had to be very careful not to get too thick...they gave me very few estrogen patches and monitored the lining pretty closely.
I hate all these unknowns and educated guesses they're always making...you're a trooper for keeping at it! I hope the next step helps your dream come true!
Here's information on endometrial biopsy:
ReplyDeletehttp://www.weizmann-usa.org/news/feature-stories/Research-on-Fertility-Yields-Unexpected-Rewards
Our clinic does endometrial biopsy and sonohystogram before starting IVFs.
Really hoping you find more answers than questions with the biopsy. And your boss sounds amazing...so glad you've got support all around you. Big hugs.
ReplyDeleteSo sorry this has happened to you. I had repeat failed IVFs and (2) chemicals before I went to CCRM. I requested the endo biopsy before I did another FET or fresh ET again. My lining tested fine.
ReplyDeleteThe only other test I did, which provided some answers to my repeat fails/chemicals, was that my tubes were blocked. Dr. Surrey explained to me that the location of the blockage was a concern since "bad fluid" could leak back into my uterus and cause a chemical, implantation failure, or spontaneous miscarriage. In the end, I ended up having both my tubes clipped to prevent this from happening.
All in all, in my opinion you have to feel you have turned over every stone in the process to have peace of mind. We all wish you the best and are here to offer our support.