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Apr 23 / Caro

Getting Back in the Saddle. Or…Erm… Stirrups

I found myself in an unusual position one lunch time a couple of weeks ago, having shifted my working day around to pop out between patients. It was the flat-on-your-back-with-your-legs-in-stirrups-whilst-someone-rummages-around-down-there type of unusual position. Except, when you have fertility issues and you’ve been through IVF, that position isn’t so unusual.

Yes. I’m back on the horse. Or back in the stirrups, at least.

Well, they do say you need to get right back on, or else you never will.

The decision to try again hasn’t been straightforward though. What it really comes down to, however, is the fact that I just couldn’t finish on a miscarriage. Or at least, not on one miscarriage. If it goes the same way again, at least we’ll know that we tried to shift the odds. I won’t be left wondering if one miscarriage was just bad luck. To end it here leaves me in far too much danger of regret. Add to that the fact that, at the moment, the desire to have another child of my own remains strong enough, irrepressible enough, to drive me to do this again. To have another chance at a chance.

One last hope.

There are things, too, that we can do differently. Chief amongst them the procedure that led to me lying in stirrups on my lunch break: The endometrial scratch. It’s a procedure that last October hit the mainstream news as a radical IVF breakthrough, boasting dramatically increased live birth rates – as much as doubling them, according to some studies.

The procedure itself is exactly what it says on the tin: scratching away at the endometrial lining. And yes, it’s every bit as unpleasant as it sounds, certainly worse than a smear test or the insertion of a coil, but fortunately it’s a very quick procedure – clearly, given that I achieved it in my lunch break! It’s carried out once or twice in the cycle preceeding IVF, and the basic theory is that it sets up an inflammatory response in the endometrium which in turn makes it more receptive to an implanting embryo. To understand this slightly counter-intuitive principle, you have to remember that the endometrium essentially wants to reject anything and everything that comes close to it. When an embryo fails to implant, or to stick, the endometrium has essentially done its job properly. But of course, when you want to be pregnant, you want the defences to fail.

There are continuous developments in fertility practices, as more is learned about conception and processes are refined. There are also fashions and fads. It’s quite possible that endometrial scratching is just that, and longer term it might not reveal the promise that early studies show. But that is a lot of promise. And it’s a cheap and easy procedure that seems unlikely to do any harm. Our consultant even cited some research which is beginning to show that it may address many of the issues that other, more expensive, trends in fertility treatment have aimed to treat – things like intralipids. The way he put it is that – for me, at least – it should address any causes of implantation failure or early miscarriage that aren’t chromosomal.

I know that with the limited supply of sperm a chromosomal abnormality is the most likely reason for my failure to stay pregnant (that is, the sperm used to fertilise my eggs probably aren’t those that out of a pool of millions would be the strongest and therefore the ones that actually made it to the egg in the first place) but opting for the scratch in this cycle means I can’t wonder if I should have tried anything else.

It’s about that need to move forward without regret again.

It’s taken me a while to write this post, and to make the decision to share it. I wasn’t sure whether I wanted everyone to know that we were going through more fertility treatment. The number of people who know “in real life” is certainly much smaller this time. A lot of people knew before partly because I wanted the support, and the ability to be able to talk about it when it was all so new and daunting. Telling friends we were having IVF was also a way of opening up about the fact that we’d been trying for a long time, that I was desperate for another child and that, yes, it did really hurt when they all kept getting pregnant so quickly!

I wouldn’t change having told the number of people I did for that cycle. Having several people to tell when it didn’t work out really wasn’t the most awful thing, and I did get a lot of valuable support. But this is cycle two. And this time I’d like to keep the pressure and expectation down. I don’t particularly want to talk about it in real life. Keeping it a secret this time feels ironically liberating.

Online, as always, is a different proposition. I can dip in and out of the fertility support communities I’ve established and I can control totally my participation in them. Trying to stay quiet and not being able to respond to a discussion on Twitter because I don’t want to reveal what we’re up to to everyone is more stifling than it is liberating.

So here I am, opening up.

Later today I’ll attend for my second scratch and collect the drugs for this next round. And then I’ll just be keeping everything crossed for success.

Well, everything that is, apart from my legs!

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9 Comments

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  1. Mia / Apr 23 2014

    Well done for getting back on that horse! I’m not finding it so easy after 2 miscarriages and I don’t know what my reluctance will mean for our fertility ultimately. Hopefully time will keep healing.

    I will be keeping everything crossed for you too. xxx

    • Caro / Apr 23 2014

      My decision isn’t the right one for everyone. Ultimately I think you have to find the path that causes you the least pain. For many people, sooner or later, that will mean stopping. Just take your time to make the choice that is right for you – you will know deep down what that is. I hope you find peace, whichever way you go xxx

  2. Melissa / Apr 23 2014

    Best of luck this time round, Caroline.
    As always, your blog is a pleasure to read and (without sounding all creepy) it’s one of the few I read that I genuinely care about.
    I hope everything goes well for you, and you’ll soon be the proud mummy of another lovely child.
    πŸ™‚

    • Caro / Apr 24 2014

      Thank you – that’s a really lovely comment to read πŸ™‚

  3. Carie / Apr 24 2014

    Well I have all my fingers and toes crossed for you again this time – hopefully the scratch isn’t too painful and lots of hope that it does something to help!

    • Caro / Apr 24 2014

      Well, I can’t lie, it was pretty painful! But fingers crossed it will all be worth it!

  4. Chloe / Apr 27 2014

    Endometrial scratch sounds highly uncomfortable. All my fingers are crossed for cycle 2.

    • Caro / Apr 27 2014

      It wasn’t nice. But like all of this, so worth it if it works. I appreciate all the finger crossing!

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