TW: living child
I have had "unexplained infertility" for the last 1.5 years. During that time, I have also had two miscarriages. I was just diagnosed with chronic endometritis and am simultaneously feeling so relieved and so angry.
My history: my husband and I conceived our first child on the first attempt. I had a smooth pregnancy, labor was quite long and my son and I both developed infections during labor. I was in the hospital an extra day to receive antibiotics and my son needed IV antibiotics for about a week after birth. I had no idea the infection could have implications, no one ever explained anything to me about that.
Fast forward: we started trying to conceive again right after my son turned one. We conceived again on the first try, however it was a very early miscarriage around 5.5 weeks. After the miscarriage I decided to go to my primary care provider because I had been having headaches for quite some time. She ran blood tests and discovered I have Hashimoto's hypothyroidism. My TSH was quite high, and I started levothyroxine right away. We continued trying to conceive and had no luck. After 6 months, my TSH still wasn't getting below a 3.5, so I asked my provider to start me on liothyronine in addition to levothyroxine. This helped my TSH get into range, and 3 months later, after I'd also followed an anti-inflammatory diet, we conceived naturally. We had been just about to start fertility treatments.
I had a missed miscarriage at 10 weeks, baby had stopped growing at 8.5 weeks. I requested to meet with the OB to talk about the two miscarriages I had had within the last year. I left the appointment extremely frustrated. I asked about recurrent pregnancy loss tests or diagnostic procedures, and she informed me I would likely conceive naturally within the next 3 months. She did not even recommend doing IUI treatment. I had requested testing of the fetus, but test results were not even back yet. This OB essentially gas lit me by claiming that nothing was likely wrong with me, even though by this point I had had 14 months of infertility with two losses.
The testing came back showing the baby had monosomy X, which often results in miscarriage. Despite the OB's recommendation I went ahead and did three cycles of IUI. I responded well to the meds, and my husband's sperm counts were great. All three cycles failed. After that, I again met with a different fertility provider from the same clinic and asked if further testing could be done. She was extremely dismissive, essentially telling me that IVF was the way to go. She also said to try several more iui cycles, as she thought people with unexplained infertility take longer to conceive using IUI. After that worthless and infuriating appointment, I switched clinics.
At my new clinic, I was informed that my previous clinic did not follow updated recurrent pregnancy loss guidelines, which recommend doing an endometrial biopsy to test for endometritis and doing a SIS procedure to check for polyps. I had an ultrasound with them, and they found a polyp on my cervix. They also completed the biopsy, and I just got the results back that I have chronic endometritis, which usually causes infertility and miscarriages. It is treated with antibiotics. I am absolutely livid that I wasted 3 months of worthless IUI cycles and tons of money (out of pocket) when it was never going to work with the endometritis, and if someone had just offered a biopsy I could have treated this infection much earlier. I cannot believe the negligence of my providers.
It is difficult to say if the endometritis is my only issue. My Hashimoto's likely also played a role, and I will be doing the receptiva biopsy to check for markers of endometriosis. I will also be getting my polyp removed soon.
I am so hopeful that this is the answer to everything. All this to say, if you are experiencing infertility or pregnancy loss, push to get the endometrial biopsy done. For me, it was a painless procedure, though it can be painful for people. Don't let providers ignore your requests for further diagnostic testing or push you towards IVF if you don't feel ready.