Recurrent implantation failure , hysteroscopy experiences

[duckling3]

Im looking for anyone's experience following recurrent implantation failure and particularly with hysteroscopy.

I had a round of fresh ivf in 2020 which ended with a healthy baby. First fet worked, but later ended in miscarriage. Since then have had 3 failed rounds of fet and been told by our consultant it's now classed as recurrent implantation failure.

She has recommended some blood tests and a hysteroscopy ( i think I'm remembering the name right- camera in the uterus)

The consultant made the hysteroscopy sound pretty unpleasant - her words were 'most women can tolerate the procedure' . She has said I can use my private healthcare and do it under general anaesthetic if it's covered by my private healthcare (which I am looking into) or I can do it under local anaesthetic at the clinic.

Just wondering if anyone has had hysteroscopy how was is? And Did it find anything which needed addressing? I'm not sure what kind of things it might find.

And generally if anyone else has repeated failed ivf/fet what testing did your clinic recommend? Or what did you do that might help?

[Sunflower360]

@duckling3 Hi, I uad a Hysteroscopy in January for a polyp that occurred following my last EC (I had 3 ECs almost back to back....so likely my body stored the estrogen which led to the polyp).

The Hysteroscopy procedure allowed the polyp to be removed and through that adhesions were also found on the lining (Dr asked if I ever had an infection which I had not, so not sure how the adhesions arose but in any case they were removed) so that was 'smoothed out' (Dr's words), my cervix was too tight so that was widened to allow a FET procedure (turns out if I hadn't had the Hysteroscopy before my first FET (which was a BFN last month but going again for FET this coming month) then the procedure wouldn't have been possible and finally had a biopsy that was clear.

I had general anaesthetic and would advise this, I woke up with bad period like cramps but would imagine that may have been from the polyp removal, smoothing of the lining and biopsy than the actual Hysteroscopy camera. I also had it covered under private healthcare, it can cost £2-3k otherwise.

Hope that helps, good luck!

[blahblahetc]

I had a hysteroscopy done abroad earlier this month, I opted and paid for general and in hindsight could have had it done without GA. I had no pain nor bleeding afterwards and wondered if they had done anything! They didn't find anything to remove, so maybe that's why there isn't any pain/bleeding.. It's supposed to also work as an endometrium scratch was what I was told..

I've read different stories, so it could be down to the individual's pain threshold + how experienced the doctor is.

[FernaFrey]

Hi Duckling, I had a hysteroscopy in January to remove a 7mm polyp that my IVD Dr and Gyn suggested to do. I had a general and would 100% have a general all over again. My IVF dr said it doesnt hurt, but my Gyn Consultant strongly suggested a general- she said if I found the coil fitting hard then absolutely have a general!

Everyone is different though.

The 7mm polyp they removed was actually in fact 1.5cm!!! Found nothing else but i do worry IVF drugs since could cause a regrowth.

Good luck! x

[Mistymist]

I had 3 hysteroscopies all under GA. I refuse to put myself through unnecessary pain. I would recommend the same since you never know the level of pain you might experience.
In terms of additional tests, I had almost all the tests under sun available in my country and I haven't been successful so far.
I have had 4 failed transfes and we are unexplained. My husband did dna defragmentation test with nothing worrying. I did immunology tests, hysteroscopies including a corrective one for a T shaped uterus.
My protocols included aspirin, blood thining shots, prednisone, intralipids, extra progesterone, extra estrogen and sildenafil for lining thickens. I even went through medically induced menopause due to suspected adenomyosis and I still haven't been successful.
What we haven't done is PGT testing ( i don't make many embryos per round) a era/emma/alice because my consultant doesn'/ recommend it.
These are just some examples of other tests or line of treatment you could ask about.
Good luck!

[Sofie19]

Hi @duckling3 I'm sorry you're in this position, it's hard. I too had a son in 2020 from IVF but all transfers since have failed. I have had 2 hysteroscopies in the past, one diagnostic and a second to remove a small polyp found on the first. I had a local for each and don't remember it to be painful so hopefully you will be okay. I think what your Dr is saying about how some women find it bareable is a bit excessive. I remember being told to take a few days off work after the polyp removal to rest etc but I didn't feel I needed it and so felt guilty but it might have been because the polyp was small. I am on an NHS wait list for another, which will be about 6 years after the last but this time it will be a general rather than a local and again, for reasons unknown as it's just diagnostic. Other recurrent failure tests could include PGTA testing, era/Emma/Alice and NK cells, all have mixed reviews. I think if you are getting a hysteroscopy there would be no harm in asking for a biopsy for endotritis if that isn't being done already.

[Serendipity24]

I had diagnostic hysteroscopy without any anesthetics. Just had antibiotic suspension, one ibuprofen and one valium two hours before the procedure. I felt period like cramps for 10/15 seconds (when the camera goes in) but that's it. A small polyp was also removed (biopsy was okay) and didn't feel any pain. If you are worried then maybe ask for local anaesthetic? Based on my experience, I would think GA is a bit excessive and I don't even have high pain threshold.

[Olivie12]

I had a diagnostic hysteroscopy with GA, the doctor won't have it any other way. Same minimum cramping and bleeding the day after.

It feels the same as an egg collection.

I would recommend you look into Reproductive immunology, it is expensive but worth it. They run tests that Fertility Specialists don't know about. They are the best for recurrent MC and repeated implementation failure .

[Lauren83]

I had a Hyteroscopy with endometrial biopsy for constant bleeding following a c section (IVF baby) they gave me a heated pad that they microwaved in the room to help with any cramps, I had mentioned all my embryo transfers had been really difficult due to extensive endometriosis and my gynae surgeon had previously said I should have the coil inserted under GA

The Doctor performing the hysteroscopy offered to insert the coil at the same time, he found access difficult so I had some local anaesthetic in my cervix, that was probably the worst part

[duckling3]

Thanks for all the comments. I'm a bit slow to respond but wanted to step away from all the infertility chat for a few weeks.

Seems a mixed response on whether general is necessary.

My consultant suggested that the procedure should be covered through private healthcare as a Gynea procedure but the insurance company didn't agree and won't cover anything after mentioning ivf/ fertility issues.

I think the cost of general is likely to be very high which means may not be an option for me now which sucks because that would have been my preference.

Fingers crossed I find the procedure as straightforward as some of the others on here!

[duckling3]

Thanks for recommending Reproductive immunology, I will have a look into that.