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  1. #1
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    Default Under what circumstances, do you do Laparoscopy, hysteroscopy and NK cell biospy?

    Just want to ask ladies who have done the lap and hysteroscopy and NK cell biopsy, what made you decide to do these procedures? is there any symptoms you experience that make you feel you may have endo or other stuff to remove? I understand in the cases of failed implantation or miscarriage, NK cell can be a cause.

    I am in a break from IVF, during the break, I have done a bunch of blood tests to investigate if anything is wrong with me to prevent implantation, all the blood test come back ok, now it is time time decide whether I would do the procedures lap etc. I am a bit hesitant at the moment due to the complexity of the procedure and the extra cost. My FS said it costs about $2500. But if my ivf cycle is not successful, I will pinch myself for not getting the investigation done now.

    Any experience, thoughts will be appreciated.

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    Hi K2 ! - Good questions!!..

    After a number of ivf's my first FS said I didn't need a lap..that everything looked normal, I had a uterine biopsy & that was fine too. I didn't really want a lap, however after a number of failed cycles and no reasons why - I got a 2nd opinion where the FS said he always does laps before proceeding...I fought this one until I read that you can have endo with no symptoms and it can 'leak' something to the embryo and destroy it..that was my reason on getting a lap..Plus I had to confirm all checks had been done - especially as I was heading towards 40 yrs - it was a time thing to cross all the tees!!

    The scars are quite tiny but dark which I cover with coverup when I got swimming..

    After 4 cycles I lurked and read heaps on info on this site re NK Cells..my FS back then didn't really support these NK Cells so had to go find a FS that did. So the NK Cell Biopsy was done when I had the lap same time.

    NK cell levels can change at any time. I'm borderline however my FS has me on steriods & intralipid drip before EPU to cover this.

    Like yourself there is no reason why 'A' grade embryos haven't stuck..as I'm on so much meds I asked my FS is it worth for me to have any more blood tests if everythings covered..he said no..BUT...I am thinking maybe I should check my thyroid again or something..times ticking and its fustrating.

    I would say check EVERYTHING - maybe there is no reason and its just a numbers game.

    Trust me ..it costs alot more cycle after cycle if you haven't tested all areas. My opinion - have the lap & the NK testing. The lap wasn't that bad for me -it really gave me peace of mind..
    Hope your break has been great!..Goodluck with your next cycle -and I hope a BFP comes soon
    Last edited by blossumflower; 30-01-2010 at 18:58. Reason: spelling

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    K2Chat - Like you I was on a break early last year and wondered after one IVF cycle and 3 FET's if a lap might be in order. My FS said he believed that everything was fine but as a routine investigation they like to do a lap if the first full IVF cycle (including FET's) doesn't work just to be sure. He said sometimes they'll find something unexpected. In fact some FS do them as a first point of call before IVF. I was a bit hesitant but on a break anyway so I went in.

    My results showed everything was normal and there was nothing to concern them, but afterwards it did make me feel more prepared to go into the next IVF cycle without nagging doubts. It was that IVF cycle that worked for me.

    No-one can tell if you it's the right choice for you, but IVF is expensive, invasive and emotional and sometimes it's best to dot your 'i's' and cross your 't's'.

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    hi Hun,

    I had one in december after four failed cycles i thought it need to be investigate i have two really small scars and I know that all is well, we also had the biopsy but have been told that if we have any more failed attempts that we would need to have another.

    you stated that you had alot of blood tests we also did that as well and genetic testing and that is where they found something with me we now have an appointment with a genetic specialist on the 9th feb.

    I can only talk on my perspective but I am glad that i have had all the testing done and it has put me in a calm place and we can work on the genetic side and find out what we need to do .

    good luck with what you decide to do

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    Thank you all soo soo soo much for your heart felt responses, I feel so relieved to see you ladies share exactly the same thoughts as I do on the investigation tests and procedures.

    Blossumflower, I totally agree with you that time is not on our side, and we will need to tick all the known to man tests before we dive into the number game.

    Nikki08, congrautlation on your pregnancy and thanks for still coming back to see us. I also read that some US clinic do lap before IVF treatment. Do you know any clinic in Australia does Lap before IVF? My FS seems not quite keen to do this for me.

    Liv01, I did Karatype blood test and come back normal, what genetic testing did you do? All best with the specialist.

    And girls, is there a best for the above tests, I sort of remeber I read from this site some lady said cycle day 21 is the best for NK cells?

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    Nk cell biopsy testing should be done from 9 days before AF due - please check on this as I'm not 100% sure.

    I too wuld like to know about the genetic testing???...do you mean pgd or chromosomal testing?

    If its PGD I was told its not fool proof so wouldn't be worth doing it.

    I've had chromosomal tests (sorry spelling) done and all came back normal.

    Gosh don't want to miss anything.

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    K2Chat - I'm not sure, I've read on BH about girls who are using clinics in Australia that do a lap as part of their work-up before starting treatments, but I went to a QFG branch and they didn't do it. However, I may be wrong but the choice I think comes down to the FS preference rather than the clinic. It was my FS who mentioned as well that some specialists like to rule out endo / tube problems before even progressing with treatment.

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    Quote Originally Posted by K2Chat View Post
    And girls, is there a best for the above tests, I sort of remeber I read from this site some lady said cycle day 21 is the best for NK cells?
    K2chat - I was told NK cell biopsy should be done 2 days before AF is due as that is the time they are most active. I had mine done CD26 of a CD28 cycle & got definitive results.

    My FC doesn't do laps/hysteroscopy at the beginning and it's not a normal thing they do. I had a lap last year but it was to remove a dermoid ovarian cyst. I may need to have a hysteroscopy in a few weeks because my hcg levels still haven't gone down to zero after my chemical pregnancy in Dec.

    Good luck with whatever you decide

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    Thanks Nikki08 and pisces11.

    Piscess11, Is Hysteroscopy similar to D&C? and can I ask you how long did you need to rest after Lap? I am going overseas on 12th Feb and my CD 26 will be 10th Feb. If my FS can do this on 10th Feb for me, I have to consider if I can get on a plane on the 12th..another option is to do this after I come back, then will it be ok to start a IVF cycle straight after lap?

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    Hysteroscopy is putting a endoscopic camera via the cervix into the womb to have a look see. Uterine biopsy (which is taking little bites of the endometrium) for uterine NK cells is done through the hysteroscope.

    D+C means dilatation and curette, which is scraping the endometrium (lining of the womb), it is usually done after a miscarriage to scrape out the product of conception ie. to do a clean up if your body doesn't complete the miscarriage process naturally. It is also done for women who have heavy periods or irregular periods to clean things out or have it sent for histology tests to see if there's anything wrong with the endometrium.

    If you only have a hysteroscopy with biopsy you should be able to travel 2 days later. D+C is probably more painful afterwards, and you have to consider being in an area away from your specialist where you can't go back if there's complication post-op. If you have a laparoscopy it is usually advisable not to fly, as they pump carbon dioxide into your abdominal cavity for the lap, and the gas takes a few days to dissipate. The gas rises with altitude and can cause the "bends" like what divers get.

    You can do a cycle straight after if you only had a look see or a small biopsy, but if you had anything else done or cut out during the lap or had a D+C you probably have to wait a while.

    HTH.


 

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