Your Stories Categories: Endometrial Scratch

Triple delight for Cambridgeshire mum debilitated with endometriosis

Endometriosis affects around 1.5 million women in the UK and is a painful and debilitating condition which is a common cause of infertility. Amy from Ramsey in Cambridgeshire suffered with it particularly badly whilst at the same time trying to conceive with husband James. Eventually surgery and IVF treatment enabled the couple to have children together.

Secondary infertility 

“I came off the contraceptive pill when I was in my late twenties so that we could try for a baby,” says Amy, aged 35. “I already had a daughter from a previous relationship so I hadn’t anticipated for one minute that we would struggle to conceive.”

After a couple of years of trying to get pregnant Amy noticed that she was starting to experience crippling pain at certain times of the month.

“It literally felt as though I was being stabbed in the stomach,” she says. “I was hospitalised twice and initially the doctors thought I might have appendicitis or an ectopic pregnancy.”

Endometriosis everywhere 

Fertility testing proved inconclusive and Amy still didn’t have a diagnosis for her pain.

“I was told it might be irritable bowel syndrome so we kicked up a bit of a fuss because it was so bad I would faint and just need to lie on the settee. James was having to take time off work to look after me,” she says.

Finally Amy got a definitive diagnosis of endometriosis, a common cause of infertility, following an exploratory operation.

“The surgeon found a blood cyst on one of my ovaries and the endometriosis was everywhere,” says Amy. “My fallopian tubes had become attached to my bowels and the endometriosis was all over my ovaries”.

After being advised that their best chance of a pregnancy was having IVF the couple initially went to Cambridge IVF but sadly after two rounds they were unsuccessful.

“We were devastated after our second treatment hadn’t worked and we thought, what are we going to do?” says Amy. “The treatment had taken its toll on my body and I felt really drained and my hair had started to fall out.”

Personalised care at Bourn Hall 

“Finding out that Bourn Hall Clinic was so close to us we decided that we wanted to give it a try because we wanted to ensure that we had tried everything before we gave up.

“As soon as we walked through the door at Bourn Hall we felt relaxed, the building feels quite homely, not at all like a hospital. It was lovely and quiet and we felt really happy with our decision to go there.”

Amy and James were given a personal treatment plan.

“With our two IVF previous treatments I had started bleeding a few days after embryo transfer,” says Amy. “At Bourn Hall our treatment was adjusted for us and I was given a low dose of aspirin and blood thinning injections as well as an endometrial scratch.”

Endometrial scratching is a relatively simple procedure which makes a small scratch in the lining of the uterus to improve the implantation rate when embryos are transferred to the uterus. Although there is little scientific evidence to support this technique many clinicians have observed improved implantation rates.

Another difference in the couple’s third treatment was that Bourn Hall transferred blastocyst embryos after five days developing in the embryology laboratory instead of the three day transfer they had at their previous clinic.

Successful IVF with endometriosis

Two weeks after embryo transfer and the day before Amy’s 35th birthday she took a pregnancy test. “The test was positive but I felt deflated and couldn’t trust it because of my two previous bleeds,” she says. “I didn’t want to get too excited and be let down again.”

Thankfully this time Amy’s pregnancy was viable – but the couple had a very big surprise in store.

At the couple’s six-week scan at Bourn Hall they found out that not only had both embryos taken but one of them had divided and that Amy was expecting triplets – a singleton and identical twins.

“It is just one of those things that you don’t expect to hear when you go for a scan,” says Amy.

“I don’t think we spoke all the way home in the car we were in complete shock! I was thinking ‘oh my god what am I going to do, where are they going to go? My house isn’t big enough, my car isn’t big enough but then I slept on it and thought ‘it is going to be okay, our house is big enough we just need to get a new car, it will be fine!’”

On 15 June 2018 Amy gave birth to her three baby girls: Roni and Lola who are identical and their sister Isla.

Life now is “hectic” laughs Amy but she wouldn’t change it for the world.

Work as a tag team

“James has taken a year off work to help me and we work as a ‘tag team’,” she says. “He wants to enjoy it as the girls were a long time coming and he wanted to take time out and help me with the three of them. The girls are pretty good sleepers and we take it in turns to get up early with them.”

As for Bourn Hall, Amy says: “We are just so grateful. The staff were all so lovely, every step of the way, and we are so glad that we went there for our last try, not just because we got our three babies but because it was such a nice place to go.”

successful IVF with endometriosis

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Double delight for Norfolk couple after polycystic ovaries affected fertility

“Neil and I met when we were 18 and had always talked about our future with children,” says Natalie, aged 35. “Ten years later we got married, and started trying for a family, naively thinking that it would just happen when we decided the time was right.”

The couple were referred for IVF treatment when Natalie’s periods failed to return after she stopped taking the contraceptive pill and she was subsequently diagnosed with polycystic ovaries.

Natalie remembers a particular low point during their treatment with IVF:

“I am a really positive person and I was genuinely happy for my friends when they conceived but I think the crunch time for me was when I had five close friends who all announced they were pregnant in the same month shortly after our second round had failed,” she admits. “I hit a low point and we took some time out from IVF treatment and went on holiday, I tried some alternative therapies such as reflexology, acupuncture and yoga. It helped me massively and put me in a better headspace.”

After two unsuccessful rounds of IVF Natalie and Neil were introduced to Dr Thanos Papathanasiou, Lead Clinician at Bourn Hall’s Norwich Clinic, who has extensive experience of treating women with PCOS and is a published author on the condition.

“From the moment we met Dr Papathanasiou we just had complete confidence in him,” says Natalie. “He is a PCOS specialist and put us completely at our ease.”

One of the issues surrounding PCOS patients undergoing fertility treatment is that there is a higher risk of the woman producing too many eggs after taking the drugs designed to stimulate egg production immediately prior to treatment. This is called ‘hyperstimulating’ and can have a very stressful effect on the body; Natalie had hyperstimulated during her first and second treatment.

“During my third treatment I was given a trigger shot to take my hormones down to rock bottom to control the hyperstimulation,” says Natalie. “Once my eggs had been collected I was given a bag load of tablets and had oestrogen patches to take my hormones back up again for the embryo transfer the following week.

“I also had an endometrial scratch prior to the injections which was something a friend had recommended to me.”

Double delight for Norfolk couple after polycystic ovaries affected fertility

Endometrial scratching is a relatively simple procedure which makes a small scratch in the lining of the uterus to improve the implantation rate when embryos are transferred to the uterus. Although there is a lack of scientific evidence to prove that the technique makes a significant difference to treatment outcomes many clinicians have observed improved implantation rates.

Natalie and Neil were told that they had produced three very good quality embryos.

“I wasn’t sure if the embryo transfer would happen but Bourn Hall told me that because of the hormone tablets I had been taking my body was in a good place,” says Natalie. “We were then given the option of transferring two embryos and we decided to do it.”

After an anxious two-week wait Natalie took a pregnancy test.

“I’d been a bit nervy and the night before I took the test my body felt different to the previous times,” she says. “I took the pregnancy test in the bathroom before going to work and nearly dropped my toothbrush when I saw the two lines, I had never seen a positive pregnancy test before. I just stood there frozen looking at it, I thought my mind was playing tricks with me. I took it in to Neil who was only waking up and when he saw the result his eyes filled up.

I then drove like a 95-year-old in to work I just wanted to wrap myself in bubble wrap, it was the weirdest feeling ever. I beamed like a Cheshire cat all day just at the thought that my body could actually get pregnant, it was amazing.”

Natalie is a primary school teacher and shared her good news with her class who followed her progress throughout her pregnancy. “The children I was teaching when I got pregnant were a fantastic group of children, I loved going in to work,” she says. “They were just so happy when they knew my news and got super-excited when I went for scans, and asked me to bring the scan pictures in and project them up on the white board.”

In May 2018 Natalie gave birth to her non-identical twin boys Freddie and George.

“It was just the best feeling when they were born,” she says. “I enjoyed my pregnancy but never really believed that it was real until they arrived.  It was just the most magical feeling ever seeing Neil so happy as well. The worst thing for me had always been that I had felt guilty because I couldn’t provide him with children because it was me who was the ‘problem’ so to be able to see him standing there holding his two boys was the best feeling ever.”

Natalie and Neil were treated at Bourn Hall Norwich. 

Double delight for Norfolk couple after polycystic ovaries affected fertility

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Endometrial scratch helps improve the chances

When the results from the fertility tests came back as ‘unexplained’ Felicity and her husband Benjamin began to despair of ever having a baby. She says: “It was really frustrating, especially as all my friends seemed to be getting pregnant at the drop of a hat.”

The couple had been trying for a family for over three years before they went to their GP for advice. Both in their early thirties, they were concerned about leaving it any longer before they went for help.

Their GP referred them to the local hospital for fertility testing and the results came back as unexplained. This is not uncommon and sometimes means that there is subfertility on both sides which means the chances of a pregnancy are reduced.

Consultation was helpful

The couple chose to go to Bourn Hall in Cambridge because they had read about the excellent success rates.

There is no waiting list for treatment at Bourn Hall so the couple soon had their initial consultation. Felicity says: “The consultation was very helpful; we talked about what IVF is, the process for men and women and how everyone is different so the treatments are tailored for each patient.

“With little knowledge about the reasons for infertility and its treatment we found the talk really helpful.”

It was a difficult road

The couple’s first cycle of treatment was IVF with Intracytoplasmic Sperm Injection (ICSI). Following egg collection a single sperm is injected directly into the mature egg, which can improve fertilisation rates. One of the resulting embryos is then transferred to the womb.

Sadly the first cycle was unsuccessful and the couple took a break before returning later in the year for a second cycle of treatment.

This time Felicity became pregnant but tragically miscarried in the early stages of the pregnancy. The couple were shattered. Felicity remembers the pain: “After the delight of finally becoming pregnant it was devastating to learn I’d miscarried. It did put a strain on our relationship but we talked through it and came out stronger as a team.”

Felicity and Benjamin returned to Bourn Hall to discuss their options and it was agreed that a frozen embryo from each of the two previous fresh cycles would be used for the next treatment.

“I was incredibly anxious after miscarrying, so a different approach gave us hope,” says Felicity.

Endometrial Scratch brings success

For their third attempt an endometrial scratch was discussed. This is a relatively new procedure that involves a very fine catheter making a small scratch in the lining of the womb.  It is thought that this procedure can help make the womb more receptive to the successful implantation of embryos and increase the chances of pregnancy

“When this was discussed I was keen to try it. Especially if there was any chance the procedure could improve our chances of having a baby,” recalls Felicity.

The couple appreciated being able to ring the clinic for reassurance at any time or to ask questions in person when they came for an appointment or scan. “The staff were really good,” Felicity says. “They looked after us so well that you felt able to put your trust in them.”

Their trust was to prove well placed when a scan confirmed that Felicity was pregnant.

Delighted to have Zachary

As the weeks progressed the couple celebrated each developmental milestone and, as she overcame her initial fears she might miscarry again, Felicity enjoyed being pregnant – before Zachary was born on 18th January 2016.

For anyone thinking of starting IVF treatment Felicity reassures: “It does take an emotional and physical toll on you and your partner and it can be a long process – it took us three attempts to have success but now we have Zachary. We are delighted and so lucky to have now to be in our position with a family!”

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