Manual vacuum aspiration after early miscarriage- please reassure me

[52States]

Hi,

Absolutely devastated and desperately seeking some advice.

I have a complicated fertility history due to PCOS. Long story short I have embryos waiting for me after banking some this year and I was all set to start transfer prep this January.

I’ve miraculously found myself spontaneously pregnant in the meantime but things aren’t measuring as they should and it doesn’t look good. I’ve been told to prepare for the worst.

I have an appointment and scan next week and things will be discussed in more details; however the wonderful fertility nurse I saw said that if we do get the concrete bad news next week that she would recommend MVA over the tablets as she often sees that the tablets don’t remove all of the tissue and that an MVA can be needed after the tablets if this is the case.

I’m like a woman possessed. I can’t stop Googling. I need to be pregnant and to keep a baby.

Please, please tell me that my periods will return to normal and I won’t be waiting for months for one to return? I really want to be able to make plans for embryo transfer. Please tell me that the risk of scarring or irreparable damage to my uterus is unlikely? Surely MVA’s are fairly safe? But i’ve just read there’s 19% of scarring? That seems excessively high.

I had a hysteroscopy 12 months ago which apparently showed a “beautiful” endometrium. I cannot believe this is happening and i’m so scared the procedure will cause me damage and leave me unable to conceive when I came so close.

Any advice or help appreciated

By MVA , do you mean the D n C? If so then I know plenty of women including myself who have had this procedure with no side effects/ risks happening to us that I know of. They need to keep you aware of them in case something does happen but generally it is like most procedures/ operations which are usually done without any risks.

I had children after D and C. Also cannot say for everyone, but my periods went back to normal straightaway.

D and C carries risk of uterine scarring and asherman syndrome. MVA is gentler as it doesn't use cutterage and because you get it done awake if they are going in too deep or rough you will feel it. I would try tablets first as many women have not needed surgery after using tablets. Think of all the women who have early terminations with these tablets with no issues. It can be a longer process but will be less risk than surgery. MVA has less risk but not entirely risk free. I had period return as normal after and got pregnant 2nd cycle after. I'm really sorry you're going through this. I hope everything works out. If you go for MVA and there's a delay in your period returning contact a gynaecologist as this can be a result of scarring.

Thank you so much for the replies. I really needed some reassurance.

The problem is that my cycles aren’t that predictable - they used to be (around 35 days) But after egg collection in June and then September they’ve been long, like 40-50 days.

Can I ask you both, when you say periods returned as normal do you mean for example if your cycle is 30 days, you got your period back 30 days from the procedure?

Before my egg collections I had a hysteroscopy that showed an apparently “beautiful” endometrium. I’m terrified it’ll all fuck up now and render me infertile

Hello
Sorry OP
I've had 2 MVAs. To previous posters - no these are not d&c in theatre.
To reassure you, they are absolutely fine procedures with less recovery than a d&c as you don't have a GA.
I much preferred them to my d&c but sadly they are only done in a few places.
Good luck x

@paradyning Thank you. Do you think chances are slimmer of scarring with this procedure? It says gentle suction is used. I hope they use Ultrasound so they can see what they’re doing 😣

As I say, so terrified for my future fertility because i’m so bloody desperate to hurry up and have a take home baby. I’m getting on a bit now.

From what I understand -yes.

D&C where I am (abroad) is done via vacuum now, they still broadly call it a D&C though. It can be done awake or under GA.

I've had three since December 2020 due to miscarriages from genetic issues. My periods returned between 4 and 6 weeks without issues. Wasn't an issue conceiving again either naturally or via IVF. I'm 6 weeks currently with my last FET. They seem to implant without issue as I've had 4 implants since the first vacuum removal.

Hi OP I'm so sorry you're in this position. I had two MVAs last year. They're not the most pleasant of procedures but they're quick and you'll be well taken care of. My last MVA was in November 2022 and I am booked in for induction for my baby next week so fell pregnant again 6 months after it.

My first MVA was in September 2022 and I fell pregnant the following month after one period. That pregnancy also failed and led to a MVA but I guess I'll never know.if the timing was related or if it was sheer bad luck.

With my second MVA it took two months for my periods to return and I did have a slight bit of residual tissue left that needed watching but it passed itself.

The suction is very gentle and the Dr keeps an eye on the ultrasound - I can't imagine it causing huge amounts of scarring, bearing in mind that your uterus is designed to have the placenta detach, leave a dinner plate sized wound and slowly heal following a successful pregnancy. I can't imagine what I experienced both times would cause trauma in the region of that.

Good luck and wishing you all the best - it's utterly shite but will get better

@Rtmhwales Wishing you so much luck. I’m so sorry for what you’ve been through- I have a complicated history too and it’s fucking awful, gut wrenching.

@Onebabyandamadcat Congratulations! Wishing you a happy and healthy delivery. Thank you for giving me hope.

Did you have an internal scan that showed some remaining tissue? I think i’ll be panic stricken if my period doesn’t return within 35-40 days. I’ll be worried sick something’s really wrong. Did you have a scan when your period never arrived.

THANK YOU everyone! You are giving a devastated, desperately stressed woman some much needed hope.

Hi @52States , I'm so sorry you are going through this. Please know that you aren't alone nor is this your fault in any way

With my 1st pregnancy I had a TFMR due to the foetus having Trisomy 13 (patau syndrome). I since went on to have an MC, and 2 rounds of IVF- one of which also ended in MC- which also wasn't making the date on scans. I'm not saying it is definite in your case though and I have fingers crossed for you x

How far along are you and how old are you if you don't mind me asking? Is this your 1st pregnancy? I was 12 weeks with my 1st pregnancy and wrongly assumed they'd do a D&C. I have a few small (<1cm) fibroids) and the consultant suggested tablets would be better. I'm happy to answer any questions you have, but have no experience of MVA I'm sorry. Feel free to private message if you prefer.

You might find support from ARC also:
www.arc-uk.org/

It will be fine. But please talk to the doctor doing it about your worries. They will give better explanation/reassurance than us.
I did have bleeding for some time after but that's normal. And two successful pregnancies following my MVAs.

You do a pregnancy test about three weeks later just to check everything is gone but mine was still faintly positive so I went back to EPAS for bloods and a scan. There was a tiny bit of tissue left but it was so small (and it was Christmas Eve and I didn't want to miss my child's Christmas) they agreed to leave it be for a while. Within a week it had passed and my period returned about two weeks later.

This is utterly shite OP but you'll get through it and I hope you have your rainbow soon

I had a miscarriage at 11 weeks (baby measuring 7) and I had the same fears, was loving in a country with variable health care quality. I opted for expectant management and 3 weeks later had natural complete miscarriage and no issues period back 6 weeks later and conceived the next month (now a 20 month old). Would you consider waiting? I think the pills are less likely to work than expectant management in the same way as induction of labour is less optimum outcomes for success than spontaneous labour. So sorry this has happened to you, its not fair 😢

*living in a country

@52States Yes my periods returned within the 30 days.
I would obviously not wish to have it at all but if need be I'd go for the DnC than the tablets. Strictly because for me, I had a very hard time with the tablets and then in case it does not work, you have to have a DnC anyway.

Which is what happened to me.

Thank you for your replies. They’re really helping.

I can’t do the pills, I can’t prolong the agony and take the risk of needing a D&C/MVA anyway.

I know MVA is the best option for me physically, even though I’m worried sick about the risk of scarring.

I’m so angry. I had a saline scan and hysteroscopy not long ago that showed a perfectly healthy endometrium. I’m terrified of messing that up and scuppering my chances of conceiving.

Surely so many women find themselves in this boat though? I’ve been reading that many conceive again 2-3 weeks after this procedure without even having a period.

I just feel like i’m being tortured. I can’t sleep or eat.

I have been in your boat, it’s a shit boat and I’m sorry.

If you are worried about scarring, try the pessaries. I had a 1cm bit of retained tissue which would have passed naturally but I was impatient and cleared it with acupuncture. Acupuncture on Monday and Wednesday, started bleeding on Friday. My acupuncture was about £120 in total and a really calming, cathartic experience after so much sadness. It made the adrenaline leave my body. I felt 3 stone lighter when I left the table.

You also may not have any retained tissue at all.

At my EPU, nurses could administer the pessaries so there was the best chance of success, is this an option?

Regarding your point about people conceiving quickly after an MVA. Some do. Many don’t. Please stay off forums and off the internet. I was obsessed with conceiving without a period like the mythical personal on a loss Facebook group, it didn’t work out that way for me and it made the fall to earth so much harder. If it happens, great- but assume it won’t. You get very little choice in the matter and it’s down to luck.

My journey to my DD looked like this: miscarriage - pessaries, 6 weeks until period returned, cycle 1- didn’t get pregnant, cycle 2- chemical pregnancy, cycle 3- my DD.

I felt exactly how you do when I was going through the wait for the conclusive scan. Chasing the pregnancy without a period and that happening for me just prolonged the torture.

Be kind to yourself. Your favourite food. Daily walks. Nourish yourself. Hydrate. Journal. Read some books about loss. But manic googling just made me
more ill and contributed to some severe mental health issues and ruined my pregnancy.

sending love x

I agree with PP. Be kind to yourself. One thing i would do differently is to stay off Google and try not overthink things. Go with the flow rather than try to change outcome emotionally and physically as it does not work.

I went a bit crazy during and after my miscarriages and it really affected me mentally.
I believe in destiny and generally an optimistic person so i remember reading different opinions etc on how to achieve success. I tried all sorts from taking extra supplements to changing my lifestyle preconception and while I was pregnant. Only to have the same outcome.
I did eventually have children but I believe it was not down to doing or thinking any differently.
It was just meant to be.
I wish I was a lot kinder to myself. Because although I am over that phase, I feel my health took a hit mentally and physically due to that phase in my life.
I wish you health and success.

Thank you, again. Your words are really comforting me.

Funnily enough @Suprima I had just started acupuncture a couple of weeks before I found out about this spontaneous pregnancy. I plan to jump straight back in once I feel well after my procedure. Is the day after the MVA classed as day 1 of the cycle? Actually you had the medical option, didn’t you? Not the surgical MVA.

I will follow my IVF clinic’s lead, as I’m likely to just go straight to embryo transfer when I can, rather than try naturally again.

I’m trying to find some good in this, if at all possible. Maybe this procedure will kick start ovulation and make my body do “normal things” I don’t think I mentioned this in my OP, but I only ovulate about twice per year and I also only have one tube.