A continuation of my appointment on Friday.
Right, so the biopsy. The very thought of it makes my eyes roll back into my head.
The biopsy is done 7-10 days after ovulation so the lining is thicker and so they can see how the womb is responding to what should be a critical implantation phase.
The first point of the biopsy was to test NK cells in the womb, something I will go into in another post.
The second reason was because it has been proven that the very act of taking the biopsy at that critical time after ovulation can be treatment in itself. It mimics the signal of implantation to induce healing and recruit stem cells to support the embryo in a following cycle. So in short, this can actually help to keep an embryo implanted as many of you ladies in North America know as endometrial scratching / biopsies are often performed prior to an IVF cycle to increase chances of success.
I was alone for the procedure, something I don’t recommend. I knew the Hubs couldn’t make it that day and we decided it was better to get it done at the right point in my cycle that they needed to rather than wait another cycle. So I went alone.
They explained the procedure starts like a smear test. A speculum is used, the cervix is cleaned, then a catheter is inserted and some cells get sucked off the lining. Thankfully it’s not a cutting type of biopsy.
But first a scan to check how thick my lining is. They won’t perform the biopsy on anything under 7mm. I told them a scan I had two days before ovulation determined my lining was too thin at 6mm but this doctor told me not to worry, that for sure it would be over 8mm by now. So wand goes in, he scoots it around. Lining? 6mm. Thin. Too thin. Oh wait. He finds one spot that measures 6.9mm. That spot is up and over and the furthest point away deep in my uterus. It’s still too thin for his standards but he says he’ll do it considering the look of desperation on my face and that I’ve travelled over 3 hours for it. But he tells me to prepare myself because this is going to hurt.
We always get the difficult uterus on a Friday afternoon, he says. Prepare yourself.
Meanwhile he’s making small talk asking me what I do for a living as he preps the tools for the biopsy. I can barely hear the questions over my pulse in my eardrums. I’m terrified I tell him. I’ve had a horrendous HSG procedure that almost knocked me unconscious with pain. He recognises how that could be an awful experience but carries on with fixing the speculum. He then explains again showing me a what looks like a 20″ catheter how far he’s got to go to get that thing in the right place. This is where most women get their sample taken (points to area just inside opening of womb). This is where we have to go to get yours (points to uterine no mans land). This might take a while and you are going to feel it.
Thankfully I had done my research unlike prior to my HSG. I was well aware this could hurt. So I took 800mg ibuprofen about 45 mins beforehand in addition to half a Diazepam. Thought I was going in prepared. Both did nothing.
First attempt at getting the catheter in doesn’t work. My uterus is too tilted, too awkward. Can I move down a little. Can I try a tilting my pelvis. Poked and prodded but still no luck.
Ok time for the bigger speculum. We’ll be right back. Nothing like being naked from the waist down, inspection lamp pointed brightly at your crotch, your feet in stirrups when everyone evacuates the room to fetch larger tools.
Bigger speculum is right! How they got that thing in there I will never know. But that was the easy part. The next attempt at the catheter. It’s going in. And in. And in. And this I can feel. It gets progressively worse as it goes in. Eventually it reaches it’s final destination and what I can only describe as pulling begins. This must be the suctioning. See on the screen this is the catheter and this is where we’re taking the sample. No I do not want to see just get the thing done! He tells me he counts down from 10 and at each number he pulls the tissue out with a yank.
After much fussing around he’s got what he needs. Or does he. Not convinced he asks if I mind if he checks the sample before removing the speculum. There’s a chance we might have to do this again. Thankfully though upon inspection he thinks we should have enough.
I’m warned that I may spot for the rest of the day and my period will likely come a few days early and I’m sent on my way.
Consensus : Painful? Yes. Endurable? Yes. As bad as HSG? Definitely not.