hCG is Outta Here; Onto Hysteroscopy & FET #3

Lots of good news today. First and foremost, my hCG is already back down to zero.  I was obviously just paranoid about this being anything other than a very early miscarriage. Notice, I don't use the term "chemical pregnancy" which is actually the medical term for a miscarriage less than 6 weeks along. I can't stand that term or "spontaneous abortion" for that matter. I know that's what appears in my medical chart, but it's just a personal pet peeve I guess. I feel those terms take away from the significance of even the earliest loss of life or make it sound as though it was the patient's choice. Is it just me?

Very happy indeed that this short lived pregnancy is already over and a new cycle has begun, because we are ready to move on from it. I think my past experience going through methotrexate shots and zigzagging levels of hCG for 10.5 weeks during our last loss scarred me mentally big time, so I panicked a little fearing this could result similarly. However, there is nothing funky here to worry about, no ectopic or anything remotely abnormal...other than extremely painful cramping and lots of bleeding.

The cramping was so intense yesterday that nothing could touch the pain...not even a double dose of 500 mg hydrocodone. I'm actually not even going to complain about the pain and bleeding too loudly though. I was SO freaking happy to see progress arrive quickly and in full force yesterday.  With every painful gush, I've been so thankful and am rejoicing that things are happening so swiftly!

Today we had our "WTF appointment".  Gotta love my RE. He deserves the "Patience with Patients" award. I walked in with a laundry list of questions and a stack of SART rates for the last five years; My questions did not poo poo around any uncomfortable topics, and I did directly ask him to defend different aspects of things I am questioning....such as inconsistent SART rates in certain categories, what I consider "less testing" requirements as compared with other clinics, and various protocol choices and differences. I am not rude by any means,  just well prepared and documented....total nightmare of a patient I'm sure. ;)

I guess for us, we are beginning to feel like we're throwing embryos into the vast unknown. 5 down and only 2 left...yikes! For me, part of this feeling is because we've never had a laparoscopy or hysteroscopy to evaluate my insides more invasively with a camera. I've always wondered if there's something being missed. I've had two HSG's which have both been crystal clear and a mock transfer prior to IVF, but that's about it. Ultimately, we all agreed that although there has been no real push for me to get a hysteroscopy previously (my clinic does not require it pre-IVF), it is certainly an option still on the table.

We did ask about hysteroscopy a couple times before IVF but were told that we didn't really need it and that it might end up being $3000 spent for nothing. Well, once you've spent $30,000 on treatments and still haven't had success that sticks, that $3000 doesn't seem so "unnecessary" anymore if there is even a teeny tiny chance of finding something that could prevent implantation. We wanted to do this surgery no matter what, but low and behold after hours on the phone to my insurance company and the surgery center, the surgery coordinator at my clinic thinks that outside of a small co-pay to the surgery center this will end up being covered 100%! They will use my uterine septum as evidenced on my HSG's to warrant an actual medical coding and turn what is normally a "diagnostic procedure" into a "medical procedure" so it's covered. WhAt the WhAt?!?!

Um, kind of wish we had the hysteroscopy done a long time ago. DUH PEOPLE! What happened was...My doctor saw in my file that I have no fertility coverage and not even any diagnostic coverage, so he is the one who told me it wouldn't be covered when we asked him about the procedure before. He obviously hadn't considered a different way of coding, which is what the surgery/insurance gal specializes in...creativity if you will. She is the one who said she could get it covered on my behalf all of a sudden. Gah! This is why "checks and balances" are so important when you're getting fertility treatments and have no insurance coverage for them. Oh well, no sense being too pissed about this "slip through the cracks" at this point...We're just grateful we found a way and it IS getting done now and should be covered. I will only believe it when I see that bill for $0 of course.

So, we've scheduled the hysteroscopy for this Friday 9/20. Dr. V will look for any polyps, and will remove anything which could be hindering implantation. We have no reason to believe I have any polyps, because I have never had anything show on ultrasound or HSG. However, there is still a chance, albeit small, he could find something in there. Here is a basic rundown of what the procedure entails...

Additionally, I have always had a slight uterine septum. This is a uterine abnormality (a slight dip in the top of the uterus) that I was born with. It's so slight and shallow that it would probably never cause issues with infertility, but it's POSSIBLE it could cause issue further into a pregnancy....if an embryo implants on the actual septum. Again, it's probably not a huge issue, but I'm not really willing to take my chances with "probably not" anymore at this point. During the hysteroscopy, the uterine septum can also be repaired, so we're kind of killing two birds with this one procedure. This is kind of gross, but this is what it looks like when they fix a septum with hysteroscopy...

It feels like we're basically flying into this procedure in only 4 days, but I am content with the decision. We both feel like it's the right thing to do before transferring our last two embryos, whether they find anything or not....at least we'll know for sure the coast is clear up in there. Should be interesting to see if they find anything!

I know many of you have had hysteroscopies. Would love to hear your experiences, tips, anything you'd like to share!