Cervical stitch loop excisions and ivf

[PepperPot88]

Hi,

Wandering if anyone could offer some insight? I’m 9 weeks pregnant with my miracle ivf baby with not the best graded embryo (which if anyone knows about ivf, I hope this reassures you that top grade doesn’t always mean it will implant!)Anyway, I’ve also had 2 loop excisions in my 20s so have scarring on my cervix. This meant that I had my transfer under sedation which isn’t usual.

Ive graduated from the ivf clinic and today met one of the community midwives. She said that she’s referring me to the pre term delivery team to monitor my cervical length. She was very reassuring and said that this was a preventative measure. I’m already on progesterone because of the ivf which she said was a good thing.

What do they do at the cervical measuring scans? Is a preventative stitch usually recommended just as a precaution? I’m not afraid of a bit of pain and I’ve been through a lot with IVF. I’m just anxious.

It’s an internal transvaginal scan, just like the ivf scans. They will screen you for infection via a swab, and measure the length of the cervix. If the cervix is under 25mm they may discuss the possibility of a cervical suture to reduce the risk of late miscarriage / early premature delivery. They are quite likely to recommend progesterone pessaries.

@khaa2091 Thanks. So it’s a fairly routine thing.

Hey @PepperPot88 ivf pregnancy too (5th round) and a severe lletz 2 years ago (that led to massive haemorrhage). Started CL monitoring at 16 weeks but was already found to be extremely short (11-14mm) so booked in for stitch the next day, but not enough external cervix left to stitch, so on progesterone only (you’ll be glad to know maybe it’s a much lower dose than the ivf standard!)

I mention the severity of the lletz as that obvs was significant in how short my cervix is now, I only had one lletz but I found out when already pregnant he’d removed almost 40mm despite telling me just 1/4 so it’s unusual to face my scenario.

also have lots of scarring (had to have an operation pre first transfer to make an opening for cathetar) which as it turns out, has been a good thing! Currently 29weeks even though they couldn’t place cerclage, and it’s likely scarring has helped cervix to remain tight and closed despite being very short it hasn’t shortened further even with the stress of a growing baby.

the CL scans are great! Honestly, you get to see the baby grow every week and you’ll be so used to tv scans from ivf. It might not be standard to get BV swabs every week, but I pushed for it as infection is part of the scope of concern with short cervix (if indeed yours turns out to be short). Best of luck. It’s great you’re being monitored and hopefully you won’t even need intervention.

I actually recognise your name so I’m sorry if we’ve already interacted! Not sure if through ivf or cervical stuff. (I also use different usernames heh)

@aLogLady
thanks so much for the reassurance. It’s positive to hear that you’ve got to 29 weeks! And I guess it does mean that you do get to see the baby more which can only be a bonus. Have you felt anxious the whole time or have you managed to calm a little?

I’ve had two loop excisions. It sounds so naive but because I was younger, I didn’t really put much thought into it. I can’t even remember how much was taken off. All I know now is that it’s shortened. Well this was my 7th embryo and I’ve been trying for years so I’m probably well known now haha. Like you, I’ve had a couple of different usernames.

Oh yes absolutely @PepperPot88 I was pretty devastated when I found out how short it was and them not being able to place the cerclage. But the combo of that and the aftermath of the lletz meant they gave me a psychologist who I’ve been seeing since. Finding out the cervix was not actively shortening and each passing week of stability gave me emotional/psychological stability. I’m now more generally scared of things going wrong/silent infection but it’s much more balanced with positive thoughts about meeting our baby.

It’s an easier emotional state to be in than general infertility and waiting for ivf rounds, that’s for sure! but either which way, let’s hope that your first CL scan is amazingly long! A woman in a group I’m in had had one leep and her cervix was nearly 5cm haha, the luxury! But at least you know there’s good reason to hope even if it is shorter than 25mm.