This post may be somewhat medical and could have a little TMI so proceed with that warning. :)
I now have a renewed sense of excitement about my next embryo transfer. As I mentioned, I had spent a good bit of time researching causes of implantation failure. Seemed there were three categories....issues with the embryos, issues with the uterine environment or a combination of the two. Embryo issues seemed unlikely in my case due to the age of the donors, their histories, and the perfect grading of the embryo used. So that left uterine environment. I read all about immune issues, natural killer cell activity, cytokines, histamines, anti-phospholipids, etc. Was planning what to say to my doctor during our upcoming regroup phone call Monday. Until I got an email from my primary nurse a couple of days ago. She said that the doctor who did my transfer procedure recommended I have a laminaria placed a month prior to my next embryo transfer. And left it at that. I vaguely recalled knowing that laminaria was a seaweed product used to dilate the cervix. This sent my focus in a whole new direction and I think I've got it now.
Doctors have had trouble accessing my cervix for some time now. The doctor who did my embryo transfer last month had never met me or my cervix previously and she also had difficulty. As soon as she got the catheter through my cervix I felt intense cramping, which is typical for me during any procedure that requires passage of a catheter into my uterus. And after the procedure I had a tiny bit of spotting. So in my research about laminaria I came upon an article written about 10 years ago by my primary doctor in Colorado and how he strongly believes that success of IVF cycles is also dependent on the embryo transfer procedure itself. And how many aspects of the procedure play a role. One issue of concern is uterine contractions that he believe negatively impact embryo implantation. They do give Valium just prior to the procedure which should help reduce the contractions somewhat, but I definitely felt cramping/contractions. He also discusses how blood or mucus on the catheter used to transfer the embryos can "contaminate" them and lead to implantation failure. So if I had spotting afterwards I can only imagine that this may have happened during my procedure. In retrospect, given these two factors, it's not surprising that this cycle did not work.
The laminaria is placed one month prior to the expected embryo transfer to dilate the cervix and make transfer less traumatic and more successful. I have now read multiple stories of women who have had failed IVF cycles, some had multiple failures, then used the laminaria and had successful cycles. So we'll see what the doctor has to say on Monday but this seems perfectly reasonable to me and I'm hoping he agrees. If so, this would seem to be a somewhat easy fix. However, I've also read mixed stories of the laminaria placement itself. Some women say it's not that bad, others describe it as excruciatingly painful. But I'm willing to do whatever it takes so I'll be scheduling the laminaria placement. Praying that this is the "fix" I need!
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