QuestionHello,
I had a miscarriage about 6 weeks ago and used cytotec to help it along. I
bled for about 9 days after the cytotec and got my period about 4 weeks after
that. My HCG levels have been dropping each week and right now they are at
9. I went in for a follow up scan and I have a 1cm piece of tissue attached to
my uterus still. My OB wanted to see if this would pass on its own so we
waited 3 weeks for another scan and it is still there (even after first period). I
have no bleeding or pain and otherwise feel great and am anxious to try to
conceive again. My question is if this 1cm piece should be dealt with first (d&c
or hysteroscopy) or if it is small enough that I can avoid surgery. OB does not
want to prescribe more cytotec since I took 2 doses already and she thinks if
it didn't come out then, it won't now. I just want to move on but don't want to
increase my miscarriage chance. What is the worst case scenario of leaving
this piece alone? Thanks
AnswerHello Amy from the U.S.,
My approach would be to do a hysteroscopy and if the tissue is present, then a minimal D&C could be done at the time. The problem with leaving it there is that it could be inflamed, which would affect potential implantation of an embryo.
Good Luck,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf
