How Long to Wait After Miscarriage?
How hard can it be to take a little break from the whole fertility topic?
Pretty damn hard if you have a post miscarriage check-up scheduled in which your gynecologist wants to discuss your fertility planning.
Originally I thought, I have to be there anyway so what’s a twenty minute fertility chat?
Oh, the ramifications.
I was on the ever so comfortable chair with my feet in the air looking at an ultrasound image hanging from the ceiling. She was maneuvering the wand around to get a look at my ovaries, my uterus, and my notorious fallopian tubes when she noticed that my left fallopian tube was slightly swollen. Not that I could identify it on the monitor but she went on explain that this could be the remnants of an ectopic pregnancy that my body is still recovering from. And then she opened the conversation, “You need to give your body a chance to heal before you begin trying again to conceive.”
I could see she thought she was going to meet some resistance from me but I already knew we had to wait out this cycle – no big deal.
Not quite.
She stopped looking at the ultrasound monitor, looked me straight in the eye, and said, “You need to wait three months before trying again.”
I protested immediately.
“What? That seems extreme. That’s how long we waited after my ectopic pregnancy surgery and this is certainly much less for my body to recover from.”
She went on to explain that my body needs one normal healthy cycle before we begin trying again. “The current cycle is your miscarriage cycle, the next one isn’t going to be normal so after the third cycle you can try again,” she said with a stern compassion. Given my long cycles though, it could be June before we can try again to conceive.
She could tell: I was not on the same page.
After a little more explaining she moved right on to the next topic. My fallopian tubes. She said it would be pointless to keep trying if in-fact my tubes are blocked or compromised and recommended that I have them checked to see if they are clear.
Oh boy. Now, I’m really not with her. Not on a different page – I’m in an entirely different book.
I already had my tubes checked (a few months before I had my ectopic pregnancy, actually) and they came out clear. So while the surgery could have created a blocked right tube, it does not seem like the test is any indication that they are going to function properly. I supposed if it turned up that both my tubes were blocked it would be good to know but I just got pregnant so, obviously, they’re not.
I started to get up and she asked me when my last breast exam was. With this infertility issue dominating my visits I had to say I couldn’t remember so I moved over to the table and she began the breast exam and continued the fertility planning conversation. Oh, joy.
She got right to the point, “You need to think about how long you are going to try on your own. I would give it six months and then consider going right to IVF.” This hit me like a ton of bricks. Basically, she’s not rooting for my body anymore; she thinks it’s time to jump ship. So to emphasize her point she then added what no one with infertility likes to hear, “The clock is ticking.”
I hate to be so critical because, if my gynecologist isn’t going to be frank and inform me about the factors influencing my fertility then who will? The thing is: I already know all this information.
I’m what one might call over-informed. I know the role age plays in my fertility. I know that IVF works best before age 35. I know that the more miscarriages I have the more bleak the statistics look for me. But – and this is a big but – if I’m listening to my body and making lifestyle changes and doing therapies that cause positive changes in my body then I feel there’s still a chance. So until the progress plateaus: I won’t be turning to invasive methods.
Before I was even out of the building I called my husband, “I need lots of hugs and some soul food.” We cooked up some fajitas – with extra guacamole and without the shells. And I got lots of hugs. But it was inevitable; we talked about our fertility planning. I couldn’t stuff my feelings and frustration away. One thing became clear; we don’t plan on waiting a full three cycles until we try again. We plan on waiting one full cycle after my miscarriage cycle. I don’t think my body needs three cycles and I know too many women that have had their first healthy child immediately after a miscarriage – one of these women is my mother.
Well, so much for that break from the infertility topic and thank god for hugs and fajitas.
Posted: March 12th, 2009 under Fertility Planning, My 2nd Miscarriage.
Comments: 5
Comments
Comment from waterbishop
Time: March 12, 2009, 4:31 pm
I’m sorry. Three cycles when they are long does sound like forever. I can understand your dismay over being told to give six months and then move to IVF. My RE staff said the same thing to me last year. And I haven’t been back.
I know you don’t want to, but a repeat HSG might be a good idea. If you now had a partial blockage in each tube you would be at a high risk of more ectopics. Who knows, maybe they would be blockages they could clear with surgery or the HSG itself. It’s still invasive though. It seems one just can’t catch a break.
Comment from Mick
Time: March 13, 2009, 6:58 am
Just curious….what’s the hesitation on going ahead with the HSG?…other than the discomfort and inconvenience? (not to minimize those). I’ve also heard that while the HSG is not intended to be ‘therapeutic’ per se, that there are lots of situations where people do end up pregnant the month following the HSG, if it happens to clear a very minor ‘cobweb’….(actually was the case for my mom!)
Also, re: the waiting 3 months…I’ve also heard of doctors recommending the 3 month wait following a mc, as standard practice, but when pushed, admit that they feel it’s good for psychological reasons, but not truly necessary from a medical/physical perspective. So, if you’re sure you’re psychologically ready, trying sooner seems logical.
Comment from admin
Time: March 13, 2009, 9:41 am
Thank you both for your input. I guess the reason I don’t want to do the HSG has three reasons.
One, it’s the loss of one cycle to try and conceive, which for me and my long cycles is quite a sacrifice.
Second, whether the procedure is helpful or effective is under debate. An HSG shows whether or not the tubes are totally blocked but it does not show if they are partially blocked nor does it reveal if there is a functional problem with the tubes like scarring (the idea that the procedure could flush out my tubes does sound beneficial though).
Lastly, the procedure was a pretty bad experience last time. The nurses inserted the device which caused me to have cramps and the doctor didn’t show up for quite a while since he was on the phone. The nurses were totally stressed if they should take the device out since the doctor wasn’t showing up. Then after the procedure, I wasn’t doing too well and started to faint. This was probably because I wasn’t allowed to eat or drink all morning and my procedure was delay by a couple of hours so I went quite a while without food and water – maybe I was dehydrated?
I know if I did it again it would probably go better but the memories of the first time are still pretty vivid.
I think I will put probably put an HSG back into the planning for later this year. Right now I just want to give my body a chance. It’s made so much progress and I feel like it’s not the right time to sacrifice a cycle.
Comment from Mick
Time: March 13, 2009, 2:17 pm
Couple thoughts….I too had to have 2 HSGs over the course of treatment. The first one was HORRIBLE with a capital H. So painful and miserable, and afterward I was doubled over in pain. I remember thinking it was the most painful thing I’d ever experienced. A couple years later it was recommended I have a 2nd one, and I was so scared. When I went in, I told them how bad the experience was the first time (not that I really expected that to help, but hoped they’d somehow be able to go easy on me). Miraculously, it was a breeze! I have no idea why, but it was not bad at all. I couldn’t believe it. So, not to say your 2nd one would be a breeze, but it’s very possible it wouldn’t be nearly as bad as the first time. (Also, not sure if they had you do this there, but my Dr. recommended a couple advil an hour before the procedure, to help reduce cramping pain).
Also…could you plan to schedule your HSG for the first half of your cycle so that it doesn’t have to cause you to skip a cycle? If I recall, when I did mine, they had me schedule it for the first half, before I ovulated, to avoid the possibility of potentially flushing out an implanted embryo, which could happen if you did the HSG after ovulation. I want to say they had me schedule it for something like day 10-12, or so.
Actually, I just did a quick GOOGLE, and found this link, where it says exactly that: “An HSG is usually preformed after your period, but before ovulation. This way it won’t interfere with a pregnancy. This commonly falls out between day 10 and 12 of your menstrual cycle.”
http://infertility.about.com/od/infertilitytesting/a/hsg.htm
So, in any case, if and when you decide to go ahead with it, it shouldn’t interfere with being able to try to conceive that cycle.
Comment from Ashley
Time: August 5, 2009, 11:42 pm
I just read your post, and I wanted to give you some comments that said, “way to go!” I see that this post was a while ago, but I applaud your efforts to work with your body in healing and life-supportive ways, whether or not you see the doctor for more tests… It is wonderful to read others on the same path.
Blessings,
Ashley
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