Tuesday 12 July 2011

Still up in the air

Well, I stayed on the buserilin while waiting for a repeat scan, so am still fully downregulated (and having regular hot flushes and night sweats - all the fun of the fair!).

Yesterday we finally made it to the clinic for the scan - it took so long because they wouldn't let me use the satellite clinic and we had to have a couple of clear days so we could go up to our main clinic.

The polyp is still there - it's at the top of the lower third of the uterus, and is about 3-4 mm, so pretty small.

One issue we have is that this clinic doesn't do hysteroscopies, so if I wanted to have it removed I'd have to arrange to have it done somewhere else. I rang XXXX clinic, and they said they couldn't do it for me, but also said that if it was small and not 'impacting on the uterus' (whatever that means), they wouldn't bother anyway.

The consultant we saw yesterday - who was absolutely lovely - was fairly equivocal about whether he thought we should abandon this cycle and get the polyp removed. He said some studies indicated that it might be a good idea, but we should make the decision ourselves and I should stay on the buserilin until we decide.

I've consulted Dr Google. There are lots of people on the forums talking about having to abandon cycles in order to have polyps removed. I also found this useful book which has information on various studies that have been done. Unfortunately, none of them is really conclusive, but it seems that the greatest evidence for polyps affecting the outcome of IVF treatment is with polyps over 1.5-2 cm (way bigger than mine). It seems that polyps don't affect implantation rates, but may have an effect on the likelihood of miscarriage - but again, this is not certain and may only involve polyps over 1 cm.

The other imponderable is that there is some evidence that oestrogen causes polyps to grow - I haven't started taking oestrogen yet in this cycle, but if when I do it makes the polyp grow larger as well as making my endometrium thicken, then this would be a bad thing.

If the clinic did hysteroscopies and polypectomies, I think it would be a no brainer - I'd just go ahead and let them do it. My problem is in deciding whether this is a big enough deal to make me not only abandon this cycle after over 5 weeks of downregulation and have a further delay of what could be a few months, but also have to find another clinic that will do the polypectomy and have yet another set of doctors poking at my bits.

Yesterday we were all ready to go ahead. Right now this minute, I think I've talked myself into thinking that if this cycle ultimately isn't successful, I would have fewer regrets if I had had the polypectomy than if I hadn't - whereas if it is successful, I won't mind the extra time and expense anyway.

This is hard - I wish the consultant had been a little less wishy-washy in his advice and had just definitely told me what he thought I should do...

3 comments:

  1. ugh so annoying, I am so sorry and wish that there was an easier way. I am like you though- I would be mad if I did not remove the polyp and got a BFN. You need to do whatever it is that will make you most comfortable. hang in there, I am rooting for you.

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  2. What a frustrating decision!! I will add my 2 cents for you to consider (if it helps, if not disregard). I had a hysteroscopy (awake, just to look around) and my entire uterus was covered in tiny polyps (sounds like they were around the size of your one polyp). I had a D&C to remove most of them, but my RE said that they most likely didn't get them all. You know my I was successful anyway and odds were I had more than 1 polyp your size. I hope you are able to arrive at a decision that you feel the most comfortable with very soon! xx

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  3. Always stuck between a rock and a hard place it seems. Ugh, ugh, UGH!!! I agree with the others. You have to do whatever is going to give you the most peace in the end, regardless of the outcome.

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