This morning at exactly 10:15am as scheduled, my fertility doctor called for the post-failed-transfer consult to talk about how to proceed with the sole remaining blastocyst that is deeply, deeply frozen and waiting to be transferred.
I was ready to argue for getting the office to conduct certain tests on me prior to going directly into a transfer prep. Luckily, arguing wasn’t needed and he even sounded sympathetic! (I’ve always said that I trust his judgement as he looks at all angles and takes the most conservative approach, but I feel far more sympathy from the nurses than from him). He agreed that we’d had an unbelievable string of bad luck related to everything in this process, especially as it relates to the donor eggs. However, like me, he wants to rely on science more than luck to (hopefully) improve the outcome of my next transfer.
So what are those next steps? Thanks for asking.
I started birth control again last week with the advent of my post-failed-transfer period (it was miserable, in case you were wondering), which means that I was able to schedule a hysteroscopy at the Jax office for Friday, July 19, rather than have to wait for my next period and delay all testing by a month. For this quick procedure (outpatient within their office), I’ll spend more time prepping and recovering from the IV anesthesia than I will actually undergoing the procedure. While I’m out, the doctor will insert a scope to view my uterine lining and look for scarring, polyps, cysts, and anything else that could be causing problems. They’ll also take a sample of the tissue for biopsy to ensure there’s no evidence of endometritis. Then I wait 7-10 days for the biopsy results to arrive.
I don’t know what happens if the biopsy comes back with an endometritis diagnosis. From what I’ve seen through the various online infertility support groups, it doesn’t negate the possibility of getting pregnant, it just makes it harder (although this is pretty hard as is).
Assuming that the biopsy comes back clean (and who knows — I’ve had twinges of pain on and off for at least the past year, if not longer, and considering everything that’s been done to that area, I have no idea if that’s normal or not), then we’ll move into the ERA test. That’s short for Endometrial Receptivity Analysis, which is basically a mock transfer. For this test, I’d go through all of the transfer prep — the two weeks of estrogen pills to build up my lining and a monitoring exam to check the uterus lining thickness, followed by a week of the twice daily progesterone vaginal suppositories and every other day progesterone-in-oil shots. Then, on what would have been transfer day, they’ll go in and grab more tissue to run another biopsy. After another 7-10 day wait, we’ll learn whether I need to be on the estrogen/progesterone medicine longer or shorter (and by how much) to make my uterus as receptive as possible to implantation of the embryo. Of course, this means that I’ll have to deal with all the medicine-related side effects again, and also go cold turkey off the meds yet again (hello hot flashes and insomnia). And then we can talk about timing for the actual transfer.
Since I have no idea what the initial biopsy results will show, we can’t make any firm plans past the end of July (approximately when the results should be available) because everything is up in the air. Again.