Hysteroscopy / Mock Transfer Today and Testing Underway

We called my RE at the beginning of July to see what type of testing we should be doing so that we can find answers related to our recurrent losses. We really can't afford IVF, but we want as much information as we can get and we know we need a lot of tests done.

Last February my OBGYN had me go in for a slew of blood tests that are standard for Recurrent Pregnancy Loss (RPL) and everything came back normal...no mutations or thrombophilias, etc. So that's good.

In June, after our third miscarriage, the OB had us get our karyotypes done, and everything came back chromosomally normal for us. Also very good.

After consulting the RE, he lined us up for a bunch of tests and had us do all the bloodwork for a "Fertility Panel." Everything came back fine...so again, very good.

Then today I had a hysteroscopy, ultrasound, and a mock transfer. I had no idea they were going to do a mock transfer, so that put me on edge, but in retrospect I'm glad they did it because I think it gave me the first glimmer of hope since we lost our twins in May.

I was also terribly nervous about possibly having Asherman's Syndrome (uterine scarring) following the last D & C to remove the placental tissue because I have had such scant periods since then (which is a symptom of Asherman's). I feared the worst, but thanks be to God my uterus looked fine. The RE saw no signs of scarring anywhere.

The RE removed the camera and did the mock transfer immediately afterward and it went very smoothly and quickly. I had some cramping right afterward and throughout the day, along with spotting, but it has been primarily uncomfortable, not painful. My understanding is that the mock transfer basically measures the uterus so that they know what tools to use and where to place the embryos in the future (should we ever get to that point).

They also did an ultrasound and measured my uterine lining and it looked "fine" for Cycle Day 12 at 9mm. My right ovary had 2 follicles measuring 16 & 17 mm, so I should be ovulating in the next few days. I'm very pleased that the lining looked good since he seemed to indicate that was essential.

The next test on my list is to get my Day 3 FSH and estradiol checked during my next cycle. My husband needs to get his sperm analyzed with a basic SA and have the DNA fragmentation checked with a SCSA. Our insurance covers basic diagnostics but nothing else fertility related, so it is adding up quickly, even in this preliminary phase of seeking answers.

All in all, everything has checked out great/ideal so far. We do not have any definite answers yet, but I think the next 2 tests will be telling. At least we are getting more information and ruling out possible causes for our losses, and that feels good. Knowledge is power.

The Burial

Since we lost twin babies, we went ahead and made a burial box for both of them, even though we only had the body of one of the twins to bury. Our other little one was too tiny to identify because he/she died so early on. My husband and I decided to do this ceremony by ourselves and picked a beautiful Maple tree in the canyon near our home for the burial site. We walked to site, dug a small hole, blessed it with prayers, laid the burial box inside, took some photos, and then prayed through a wonderful liturgy (miscarriage memorial) produced by the Episcopal Church. The text of that service can be found here: http://www.episcopalchicago.org/about/about-admin/documents/HannahsHopesRachelsTears.pdf .

Here's a prayer from it:
We commend to your mercy, O God, our child N., that death may be for her the gate of life and peace with you. At your heavenly banquet, may we rejoice with her and all your saints to see you face to face, one holy and undivided Trinity in glory everlasting. Amen.

We cried quite a lot and hugged. Finally we placed the soil over our little one's box and placed flowers and rocks (a Jewish tradition) on the burial site, one rock for each living family member (3). It gave me a sense of having honored my babies the best way that I could with a sacred rite.

Now I blow a kiss and remind my little ones how much I love and miss them every time I walk past that precious burial site. Tears often flow, bidden or unbidden.

D & C Following Misoprostol

By way of update, the Misoprostol failed to evacuate all of the fetal tissue after my miscarriage. This was discovered at my 12 day post-treatment ultrasound when most of the placenta was found. It is my OBGYN and RE's opinion that Misoprostol works well for very early miscarriages or chemical pregnancies, but for later or "bigger" pregnancies (6 weeks and over), it is not as effective. I should have been close to 9 weeks along by the time we discovered the fetal heart beat had stopped. Sadly, I had to schedule yet another D & C to evacuate my uterus because leaving the left over tissue could lead to a serious internal infection. In fact, I was still losing portions of the placenta several days after the D & C.

Unfortunately, I have been having symptoms of Asherman's Syndrome (scarring of the uterus) since the D & C and am very concerned that this last D & C has done damage which can impair fertility. This is more common than people realize after a D & C because the uterus is so fragile during and immediately after pregnancy. Often the scarring is caused by the tissue tearing away from the lining of the uterus and nothing more. My symptoms have included extremely scant bleeding/periods (especially in comparison to my normally very heavy periods) and uterine pain. I will be getting a hysteroscopy to have this checked into.