Understanding Endometrial Thickening After a D&C: Causes & Next Steps

Question
Hi Sara, I hope you can help me.  I had a D&C almost 8 weeks ago due to foetal demise at 12 weeks.  I didn't bleed that much after the D&C, but continued to spot for about 6 weeks.  I went to my doctor who sent me for an ultrasound - he also did my bloods and HCG came back at 20.  The ultrasound showed -

"a thickening of the endometrium at the level of the fundus.  The endometrium measures up to 2cm in thickness and appears heterogeneous in echotexture.  However, the adjacent myometrium also appears hetrogeneous in echotexture.  The abnormality extends towards the serosal surface of the fundus.  The exact nature of this finding is uncertain.  It may represent an infection or haematoma"  

My GP has consulted two ObGyn's at our local hospital and both have said just to leave it.  I got my period last week and my GP thought that it should come away with my lining but another ultrasound yesterday showed that it was still there (18mm thick).  I have started to bleed again today (red) with cramps and I just don't know what to do.  We want to start trying for another baby (I am 38) and two months has gone by already.  Do you think that I require another D&C or should I just wait it out.  Can I fall pregnant with this thickness still there?  Is it safe to do so? Is there something I can do or take to release the blood? Look forward to hearing from you Sara, many thanks Deb

Answer
Hi Deb,

I am curious if you had blood drawn again since the one where the HCG level was at 20.  It needs to be negative, so your body will be able to get pregnant again.  I am wondering  if this thickness is possibly some small remnant of the pregnancy before your D&C?  Well, I would say to follow the advice and give it another 2-3 weeks to see if this clears up.  Your miscarriage you had was pretty far along and your body probably needs more time to adjust.  There is some medication to help you shed the lining of the uterus, but I cannot remember the name(s) of the medication; perhaps bring that up to your doctor?  I am so sorry for your loss and my thoughts are with you.

Take care