Womb Scratch

What is a womb scratch?
Could there be a more terrifying sounding term than “womb scratch”? It is the process whereby doctors make a tiny scratch to the endometrial lining to stimulate fresher, healthier cell production and increased white blood cells to the area. It is generally used for women who have experienced endometriosis, or suspected endometriosis, or are on the older side of the fertility rainbow. Studies have shown that it increases chances of implantation and live birth by 50%! That is a significant increase in anyone’s estimation. So when the nurse casually informed us that I had been put forward for an endometrial scratch, as I had suspected past endometriosis and am on the older side, I said yes I will do it without hesitation. Then I got home and panicked.

There are two worrying aspects to the womb scratch process. Firstly, you have to have protected sex for the cycle of the scratch. Everyone who has been trying to get pregnant knows that missing a cycle feels like missing a huge opportunity. I swung wildly between thinking that this specific cycle could have been the magical one that would have naturally gone right, to being incredibly grateful for the opportunity and science to perform these amazing procedures to help with fertility.. Luckily gratitude won out.

The second worry was that my womb was to be scratched. Anyone I mentioned it to, men or women, involuntarily flinched when those terms were spoken. Years of nurturing my womb and imagining it as a safe space to protect and carry our baby had to be turned on its head. My endometrial tissue would be torn. On purpose. But for a hugely increased chance of success.

What to expect?
We went to the unit together for the procedure. The hospital does not allow men into the specific medical pods. This is not for hygiene or safety reasons. The doctor explained that men were asked to stay in the waiting area as not all but far too many of them had fainted in recent years. The medical staff are not able to attend to the passed out male partner, which causes potential liability as well as stress to all involved. The woman’s medical and emotional safety is their priority. The medical team complete the necessary procedure for the woman and then would have to attend to the passed out male partners. “What about women partners or companions”, I asked. “Oh we let them in”, said the doctor, “women know how to be there for one another in the realest terms”.

The womb scratch was relatively simple and straight forward. It was easier than a pap smear for me and many times easier than the HCG test (blog post on fertility MOT tests to follow). The major discomfort is that you have to go in with a full bladder. They recommend filling your bladder up an hour before the procedure. Having a full bladder plus sitting in a waiting area in a state of nerves does not really add up to great comfort.

But the procedure itself is very, very quick. The doctor inserts the speculum and the usual adjustments occur to ensure the correct angle to the cervix. An aspirator is inserted through the speculum into the womb.The pain of the scratch, which is actually a tiny suction device hoovering up cells, is brief and you definitely feel it – like a bolt of concentrated acid lightning to the centre of your being. Apparently I swore out loud. The pain lasted the same time it took me to utter two swear words. There was some dull aching after, and some light bleeding.

Totally manageable for a couple of hours straight afterwards. I did get quite nauseous and bloated later that evening and went to sleep very early. I think that was because of the 4 giant antibiotics I had to take on an empty stomach. Probiotics are firmly on my list of must haves now. Other than that, the process was quick, simple and completely manageable.

Top Tips:
1. Have someone with you for support if possible. Mindless chatter is helpful to distract from the nerves and full bladder while waiting.

2. Definitely take pain medication before hand. I wasn’t advised not to by the clinic, so I didn’t ask, and did it anyway as I was fearful of a repeat HCG experience. I used a muscle relaxant that I take when having really painful period pains, not just a couple of paracetamol, and that helped I think in the insertion of the speculum, adjustments and the cramping.

3. Visualise something that makes you happy. Quite by coincidence the doctor and I spoke about a place that we both had in common throughout the procedure. I visualised the ocean and the forests and it was very calming. Usually I ask a million questions about the procedure. So this discovery was really lovely and a nice change that I’m going to make.

4. Probiotics to counter the nasty side effects of antibiotics. Don’t get me wrong, antibiotics are wonderful, but the nausea, IBS type symptoms they induce in me are awful.

5. Panty liners are useful. You pretty much start spotting immediately afterwards for about a day.


Top 10 Tips for Preparing for IVF

Nothing can quite prepare you for hearing the words that you have no option but IVF. For many of us, we imagine a pretty straight forward process to become mothers. Whether IVF has come as a shock for you or is an option you’ve considered for a while, it is a daunting path. There are ways to manage the anticipation process and prepare for what’s to come.

Here are top 10 tips for preparing for IVF:

1. Surround yourself with kind, nurturing, supportive people.
If like me, at first you view IVF as an impending horror fest filled with needles, hormones, invasive examinations, test tubes, and very likely failure, you need to talk, talk, talk and process, process, process. Good and kind people will help. Disclosure is different for every one. Be selective. Talk to people who get it, preferably someone who has been through IVF or is going through IVF.

2. Hope is your friend
It is healthy to be realistic about the odds of success, but HOPE is our friend. Even if hope seems a fickle friend, she’s there to keep us out of despair and keep us positive. Don’t lose hope, even if the odds don’t look great, theres always the possibility it could work.

3. Get your finances in order
IVF is expensive. Luckily in the UK the NHS does provide funding for IVF if certain criteria are met. Understandably the funding is limited: in some postcodes 1 round is the norm, in other postcodes 3 rounds. Even with funding, certain blood tests, procedures and processes are out of pocket expenses. Assess the financial implications of IVF and do what works for you. You’d rather go in with eyes open understanding the clear costs and the hidden costs than be shocked at the large bill at the end of the process. Most add on processes increase chances of success, so most people quickly say yes. You don’t have to say yes immediately – think yes, and then figure out what works best for you.

4. Fill in paperwork together
There are a lot of forms. In our case for both of us. The forms can be daunting. In my experience, the forms are not user friendly and the technical terms (“viable blastocyst”, “geriatric pregnancy”, “destroy samples”!!!) are off putting. What happened to nice terms like “mum” and “baby”? It can feel like you’re in a large medical factory. Filling in the paperwork together can help ease the discomfort. From a practical point of view you also need to ensure that your answers are the same on key issues like egg storage, use for research purposes, etc. The paperwork helps prompt these discussions.

5. Train for IVF
Treat preparation like an athlete would. If you have the time, and haven’t already, start exercising regularly to improve your overall health and vitality, take the correct vitamins and minerals especially folic acid, eat balanced and nutritious meals, reduce alcohol and caffeine intake, drink 2 litres of water a day, stop smoking, start acupuncture which helps with stress reduction and increasing blood flow to the womb and ovaries. Ideally to optimise egg health you want to start this three months before egg collection. But it doesn’t hurt to start whenever you can. IVF is definitely about falling pregnant, but it is just as much about our experience as women too. Our health and fitness is paramount. Although there is no clear prediction of how our specific bodies will respond to IVF, it is common sense that being in good physical and mental condition can only help in the short term and long term.

6. Pre IVF counselling
Most clinics offer pre IVF counselling. If your clinic does not, try to find an IVF counsellor who can see you and your partner for at least one session. It really helps to discuss options and feelings with a professional who gets it, has seen it all and wont judge. A safe space outside of your home where you and your partner can say anything you need to each other is very helpful and nurturing, and ensures that you are both heard and valued.

7. IVF time planner
IVF has its own schedule. It is unpredictable and uncertain. But if you can plan fun and/or distracting things to do whether it is going to a musical or watching an entire series of RHOBH in one day, then do it! Make the time for whatever is special and comforting for you. If possible, schedule time off work in advance. This is very hard for most people, but if you are lucky enough to do so, put it in your calendar.

8. Stock up on what you need
Again, this is different for everyone, but it is helpful to identify what you might need. A good tip is to imagine what you might need for a bad period and make sure you’re stocked up on the necessaries: panty liners, pads, comfy undies, pyjamas, loose clothing, download tv series/movies/books/podcasts, arnica oil for bruising, permissible pain medication, chocolate, etc etc.

9. Be kind to yourself and one another
Gently does it. Be as kind and gentle to yourself and one another as possible. It is natural to feel angry at yourself or externalise the anger and grief. Acknowledge your feelings and thoughts and then actively be kind and gentle. Treat yourself and your partner as you would your baby – with unconditional love.

10. Let go of certainty, embrace constant change
You can plan, plan, plan and prepare as much as possible. All of that will help manage the process. But ultimately the process of IVF is about letting go of certainty, submitting to the process and embracing constant change. And keeping the HOPE alive!

Is it possible to have a joyful IVF experience?

Is it possible to have a joyful IVF experience? Is it possible to revel in the journey, to wonder at the marvels of technology and science, to see this opportunity as a gift from the universe? Can I approach this experience with reverence and gratitude, the way I would any other major life experience, regardless of the outcome? How do I let go of the end goal when having a baby is the most precious and fulfilling experience I can ever imagine. It is the thing my husband and I both long for with an almost incomprehensible depth. How is it that we can love a not yet exisitng little person so deeply when our baby is only a glimmer of hope, of possibility?

Can I move from fear of the physical aspects of IVF – fear of the side effects, fear of the loss, fear of the shame, fear of the very real possibility of another failure? How do I shift from the trepidation and anguish that I am feeling today, this morning, to an expanded sense of possibility? And how, for the love of all things good, do I relax when all I’m being told to do is relax?

We’ve been trying for a child for three years now. For some people, three years is not a long time. For us, its been a series of 36 four-weekly cycles of hope and rock solid belief that we are pregnant to shock and sorrow that we are not. And then the cycle begins again. A few months ago we were told that our only option is IVF. We start next week. This blog will follow our journey, from my perspective.