As many of you know, after our third frozen embryo transfer was unsuccessful in July we opted for surgery. We wanted to get eyes on all aspects of my reproductive system to see if we could get any answers as to why we cannot get or stay pregnant. In this two-part blog, I will go through the surgery itself and recovery. In the next part, I will review the results and what they mean for our next steps (so stay tuned for that!).
Before I get into my procedure, let me give a quick overview as to what each procedure entails.
HYSTEROSCOPY
All of the information provided in this section is taken directly from the pamphlet my OBGYN gave me during my pre-app appointment from The American College of Obstetricians and Gynecologists.
What is Hysteroscopy?
A hysteroscope is a thin, lighted telescope-like device. It is inserted through the vagina into the uterus. The hysteroscope transmits the image of the uterus onto a screen. This allows a healthcare professional to see the inside of the uterus during the procedure. Hysterocopy can be used to diagnose or treat a problem.
Why is it Done?
Common uses for a hysteroscopy are:
Find the cause of abnormal bleeding
Look for fibroids or polyps If fibroids or polyps are found, a special instrument passed through the hysteroscope can be used to remove them. If no growths are found, a tissue sample can be obtained for biopsy.
Remove adhesions that may occur because of infection or from a past surgery
Diagnose the cause of repeated miscarriage when a woman has more than two miscarriages in a row
Locate an intrauterine device (IUD)
Perform sterilization, in which the hysteroscope is used to place small implants into a woman’s fallopian tubes as a permanent form of birth control
For a full account of my first hysteroscopy, click here.
DILATION & CURETTAGE
All of the information provided in this section is taken directly from The American Society for Reproductive Medicine.
Dilation and curettage (D&C) is a short surgical procedure that removes tissue from your uterus (womb).
How is the Procedure Done?
Your doctor will slowly widen the opening to your uterus (cervix). After dilating (opening) the cervix, tissue from inside the uterus is removed with a scraping instrument known as a curette, a suction tube, or other specialized instruments.
DIAGNOSTIC LAPAROSCOPY
All of the information provided in this section is taken directly from the pamphlet my OBGYN gave me during my pre-app appointment from The American College of Obstetricians and Gynecologists.
Uses of Laparoscopy
Common uses for a laparoscopy are:
Endometriosis
Adhesions
Fibroids
Ovarian cysts
Hysterectomy
Infertility
Sterilization
Ectopic pregnancy
The Procedure
After anesthesia is given, a small cut is made below or inside the navel. A gas, such as carbon dioxide or nitrous oxide, is usually put into the abdomen. The gas swells the abdomen so the pelvic reproductive organs can be seen more clearly. Your body will be tilted slightly with your feet raised higher than your head. This shifts some of the abdominal organs toward the chest and out of the way. The laparoscope will be placed through the cut. Another cut is often made above the pubic region. Through this cut, an instrument is used to move the organs into view. Usually, the laparoscope projects images of the surgery onto a television screen. Other surgical instruments can be inserted through the scope or through other cuts. After the procedure, the instruments are removed and the gas is released. The cuts are then closed.
MY SURGERY
So now that you have some background on the procedures themselves, let me walk you through what the day of surgery was like for me. Actually let’s start with the day before…
I woke up the day before surgery and had to do something I hate...I took a home pregnancy test. It wasn’t because I had hopes I was pregnant naturally (that ship sailed a long time ago unfortunately). It was because I had to 100% confirm I wasn’t because that night I would be taking the same medicine I took to make my body miscarry our baby (Misoprostol). The reasoning behind this was to help soften my cervix in preparation for surgery. So besides just the normal pre-surgery anxiety nerves, I had to start the day before the procedure seeing my 31st negative home pregnancy test and then reliving what started my miscarriage that night. It sucked….end of story.
The day of surgery, the plan was to arrive at the hospital at 830am (for a 1030am surgery). The hospital ended up calling us around 7am and said there was a cancellation and they asked us to get there early. So we packed up and headed there as quickly as we could. We got checked in, filled out the paperwork and was taken back to the pre-opp area. We started by taking another pregnancy test (I don’t know if I could have rolled my eyes harder when the nurse came in to tell me the test was negative) and all of the typical pre-opp items. I got an IV (after 2 painful attempts), met with my OBGYN and the anesthesia doctor, and was given some tylenol to assist in pain management immediately after the surgery. Then it was time...they wheeled me to the operating room, I got on the bed and then I don’t remember anything after that.
The surgery lasted a hour and I woke up in post-opp shortly after. I was in a lot of discomfort waking up but they managed my pain well. My OBGYN came in to go over the photos from the surgery and confirm my post-opp appointment scheduled for the week after. I stayed in the post-opp area for about 40 minutes (I think...I really don’t have a lot of memory of the actual amount of time) and after getting a dose of pain meds, it was time to head home to start the recovery process.
MY RECOVERY
Luckily, there is not much recovery after a hysteroscopy with D&C. Unfortunately, the laparoscopy came with some serious pain and discomfort. For about 4 days after the surgery, my stomach was incredibly sore and tender. I found it hard to get out of bed (because I couldn’t use my stomach muscles to sit myself up) and walking the first couple of days was difficult. I was told that not all the gas gets released after the laparoscopy so it is very common to have shoulder pain. The trapped gas can irritate the phrenic nerve causing pain in the shoulder. I felt it most after getting up from laying down. The pain would be intense and sudden.
Thanks to other infertility warriors who have had this procedure and Dr. Google, I felt very prepared in the recovery. Here are some of the things I made sure to do that seemed to help a lot:
Meal prep I was not able to stand and cook a full meal for almost a week (either from the pain or just the extreme fatigue I felt). The week before surgery I made a few freezer meals and soups that made it easy for my caretakers or myself to handle.
Wear very loose clothing to the hospital Knowing I would be in a lot of pain and probably bloated after surgery, I picked out a loose maxi dress with a built-in bra. This would allow me to not have to put on multiple layers of clothing afterwards and have nothing tight resting on my stomach.
Rock the granny panties You aren't going to want anything tight on your stomach or above your pubic bone as that is where your incisions will most likely be. Make sure to wear comfortable underwear so there is nothing putting pressure on your sore spots and you can also put the pad on (in case you are still bleeding after surgery).
Heating pads for shoulder and stomach At any given time, I had a heating pad on my stomach and my shoulder. Make sure to have 2!
Pain meds Take your pain meds - don’t be a hero! You will be in pain and that’s why they prescribe you pain meds. I took my pain medicine around the clock for 3 days after surgery. That 4th day I tried to only take the ibuprofen and ended up having to take a pain pill by the late afternoon. After that I was able to rely on the ibuprofen and stop taking the pain meds.
Release the gas Okay...this isn’t the prettiest topic but it’s a big part of this procedure’s recovery. The trapped gas is going to cause all sorts of discomfort so do whatever you can to keep it moving. Here's what I did to help" - I started taking Colace and Gas X as soon as I got home from the hospital for a couple days straight - Peppermint tea is very good for getting the gas to move (and it’s just a very soothing drink when you are feeling all sorts of icky) - TMI alert (Sorry husband)...Let it go! The minute I felt gas pain or the need to have a bowel movement, you have to let it go. The more you can release, the better you will feel - trust me! You do not want the extra pressure on top of the pain and discomfort you are already feeling.
Make sure to follow all post-opp instructions you are given. It’s a tough recovery, but not impossible.
Stay tuned for part 2 where I will share the results of the surgery and how that will impact our next steps on our infertility journey.
*This is not meant to be medical advice. Be sure to consult your doctor with any medical concerns. This is the account of my personal journey through infertility*
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