Cervix Denies Entry But Plan Continues

IMG_5254My July cycle to do the endometrial biopsy and ERA (Endometrial Receptivity Array) did not go as planned. My doctor had me go through the same controlled cycle that we would do for an embryo transfer but instead of transfer day, we would do this procedure. The hope was that 1) the endometrial biopsy would make the uterine lining “sticky” for the following cycle’s embryo transfer and 2) the ERA would let us know if we were transferring the embryo on the right day of the cycle for optimal endometrial receptivity. Sounded like a fabulous plan to me. There is no solid evidence that the endometrial biopsy directly increases chance of pregnancy, but I was willing to do it in hopes that it could make a difference for me.

The endometrial biopsy is not a fun procedure and I had done it once before and it did lead to my second pregnancy. The first time doing this procedure was without any pain medication and wow, that was a mistake. I remember getting ready for the procedure and the doctor asking me so calmly if anyone had warned me ahead of time of the pain level. Um, no, I was expecting it to be something like a pap smear. He proceeded to tell me it’s about a 7 out of 10 on the pain scale. Holy crap. Yep, he was right. Luckily it’s not a long procedure but I did not want to go through that again. For this second time around I was very apprehensive about the pain, so my doctor was able to do a paracervical block (lidocaine injection) and I could tell it was helping a lot. However, after what seemed like forever, staring at the ceiling, scared to move, and at least 4 tries by the doctor, he could not get through my cervix. It was such an unnerving experience and very frustrating for both of us. It turned out that my cervix had developed nabothian cysts. Luckily they are benign and not harmful, but due to the cysts, it was not possible to pass the instrument through the cervix. As I was lying there in tears, clutching the hand of the nurse and quickly becoming her new best friend, I could tell it was not easy on my doctor either. So we called it a day and decided to think things through for a few days. That procedure was now out the window and I’d have to consider starting over again.

In the follow up conversation with my doctor barely a week later, I was in the precise condition to start another controlled cycle. After a thoughtful discussion, we all decided to move forward with the embryo transfer cycle and skip the other procedure all together. We are now two weeks into this process and the frozen embryo transfer will happen in one more week on August 21. Due to the cervix denying entry just a couple of weeks ago, we decided to do a mock embryo transfer and this happened yesterday. He was able to see that some of the cysts had gotten smaller, but also mapped out the path through my cervix on the ultrasound. It’s like a labyrinth in there! It is not a direct shot. There is a hard sharp turn on the way in. Luckily, the mock transfer went without a hitch and was very quick, so that boosted all of our confidence for next week. We are quickly approaching attempt number 8 and I’m trying my best to be healthy, stay rested, get in plenty of acupuncture and ready to accept positive energy, prayers, and happy thoughts from anyone who will give them.

Photo by – CJE, Catalina Island

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