Need to take Cytotec to start miscarriage--advice?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I'm so sorry for your loss, OP. I had a missed miscarriage where the baby had stopped growing 4 weeks before. I opted for the Cytotec and it wasn't as bad for me as some of these other posters. The cramping was painful, but definitely not unbearable. I think I just took ibuprofen. I didn't have any vomiting or diarrhea. The Cytotec didn't work for me after about 36 hours, so I got a D&C instead. The D&C ended up being a really positive experience for me. I got pregnant again 6 months later and just had a baby.

Based on my experience, I would take the Cytotec over doing nothing but call your doctor for more explicit instructions and to ask about pain management. I personally preferred to get the physical part over with so I could start healing emotionally. Good luck to you. I'm so sorry you're going through this.

FYI, the WHO recommends that the effectiveness of Cytotec be judged after ONE WEEK, not 36 hours. Shady Grove allowed 3 days, which I thought was bullshit. It's over 90% effective if you give it the full week. Look up the WHO info on misoprostol. It is used safely all over the world. If I were a cynic I'd say that it's not used in America very much because it's such a cheap and non-interventionist option. And doctors who do use it don't use it properly and then claim it doesn't work. SG told me it was only 60% effective. If it's 60% effective for them, they are using it wrong. Luckily I did my own research.

I'm one of the PPs who thinks cytotec is a better first-line option. I just used it last weekend, and I'm not sure everything has passed, so I'm not sure if I'll need the D&C anyhow.

But here's my question, what is the effective way to use it? I've read most doctors give two doses. Mine only did one, and he's definitely pushing the D&C. I have a slight worry that maybe I should have gotten two doses.

But I agree, it is much less invasive than the D&C. And I don't think people realize the risks with the D&C. It's possible as well that they don't get everything out with a D&C. After all, it's not like they have great visibility where they are scraping. And that's what scares me the most.

I have also read in some places that it actually isn't a big deal if not everything comes out right away. I don't know if this is true, but I read somewhere that usually, it will all come out in your next period.

I have strong reservations about the D&C. I felt like I was pushed into one on my last miscarriage and it reduced my lining too much and possibly caused damage that led to the current miscarriage. It seems to me a relatively recent thing that D&Cs are standard after first trimester miscarriages. So many older women who have had early (first trimester) miscarriages just say they passed everything naturally. They didn't even have the option of the cytotec. Sure, it was drawn out and miserable, but it doesn't sound like they all got infections. It seems to me that the D&C (where they force open your cervix and use tools to scrape out your uterus) has a greater infection risk than a natural miscarriage or one that is *sped up* with cytotec. Perhaps there aren't more infections with D&Cs because they give you doxy (antibiotic) during the procedure and after. It isn't necessarily that they get everything out.

But again, I'm curious to hear what you think is the correct way to use the cytotec. [/quote]

http://www.misoprostol.org/File/guidelines.php

For missed miscarriage, the guidelines supported by clinical studies are:
- 800mcg vaginally 3-hrly (max x2) or sublingual 600mcg 3-hourly (max x2)
- Give 2 doses and leave to work for 1-2 weeks (unless heavy bleeding or infection)

I often hear of dosages that are two low, or are not repeated, or (most common) not given enough time to work.

I am not asking anyone to trust a stranger on the internet rather than their own doctor. I am urging women to do their own research, to learn about global standards and the long history of the safe use of misoprostol, and not to assume that every reproductive endocrinologist/gynecologist/obgyn is up to date on the research about the prevalence of Asherman's and the safe use of misoprostol/cytotec. Because I can assure you: they are not.

70% or so of women will sail through a D&C with absolutely no problems. But that's cold comfort if you're part of the 30%.

Please, please educate yourself. I didn't and I lost the ability to have another child. Educate yourself and make sure that you are comfortable with the relative risks and benefits of D&C vs. misoprostol.

[Anonymous]

But again, I'm curious to hear what you think is the correct way to use the cytotec.

http://www.misoprostol.org/File/guidelines.php

For missed miscarriage, the guidelines supported by clinical studies are:
- 800mcg vaginally 3-hrly (max x2) or sublingual 600mcg 3-hourly (max x2)
- Give 2 doses and leave to work for 1-2 weeks (unless heavy bleeding or infection)

I often hear of dosages that are two low, or are not repeated, or (most common) not given enough time to work.

I am not asking anyone to trust a stranger on the internet rather than their own doctor. I am urging women to do their own research, to learn about global standards and the long history of the safe use of misoprostol, and not to assume that every reproductive endocrinologist/gynecologist/obgyn is up to date on the research about the prevalence of Asherman's and the safe use of misoprostol/cytotec. Because I can assure you: they are not.

70% or so of women will sail through a D&C with absolutely no problems. But that's cold comfort if you're part of the 30%.

Please, please educate yourself. I didn't and I lost the ability to have another child. Educate yourself and make sure that you are comfortable with the relative risks and benefits of D&C vs. misoprostol.

If you find the research difficult to read, I'm happy to answer questions (I do this stuff for a living).

[Anonymous]

Anonymous wrote:

But again, I'm curious to hear what you think is the correct way to use the cytotec.

http://www.misoprostol.org/File/guidelines.php

For missed miscarriage, the guidelines supported by clinical studies are:
- 800mcg vaginally 3-hrly (max x2) or sublingual 600mcg 3-hourly (max x2)
- Give 2 doses and leave to work for 1-2 weeks (unless heavy bleeding or infection)

I often hear of dosages that are two low, or are not repeated, or (most common) not given enough time to work.

I am not asking anyone to trust a stranger on the internet rather than their own doctor. I am urging women to do their own research, to learn about global standards and the long history of the safe use of misoprostol, and not to assume that every reproductive endocrinologist/gynecologist/obgyn is up to date on the research about the prevalence of Asherman's and the safe use of misoprostol/cytotec. Because I can assure you: they are not.

70% or so of women will sail through a D&C with absolutely no problems. But that's cold comfort if you're part of the 30%.

Please, please educate yourself. I didn't and I lost the ability to have another child. Educate yourself and make sure that you are comfortable with the relative risks and benefits of D&C vs. misoprostol.

If you find the research difficult to read, I'm happy to answer questions (I do this stuff for a living).

I call bs on your 30 percent statistic, particularly for women in the US going to a high end doctor/hospital. I think you have your own personal agenda.

[Anonymous]

Anonymous wrote:

But again, I'm curious to hear what you think is the correct way to use the cytotec.

http://www.misoprostol.org/File/guidelines.php

For missed miscarriage, the guidelines supported by clinical studies are:
- 800mcg vaginally 3-hrly (max x2) or sublingual 600mcg 3-hourly (max x2)
- Give 2 doses and leave to work for 1-2 weeks (unless heavy bleeding or infection)

I often hear of dosages that are two low, or are not repeated, or (most common) not given enough time to work.

I am not asking anyone to trust a stranger on the internet rather than their own doctor. I am urging women to do their own research, to learn about global standards and the long history of the safe use of misoprostol, and not to assume that every reproductive endocrinologist/gynecologist/obgyn is up to date on the research about the prevalence of Asherman's and the safe use of misoprostol/cytotec. Because I can assure you: they are not.

70% or so of women will sail through a D&C with absolutely no problems. But that's cold comfort if you're part of the 30%.

Please, please educate yourself. I didn't and I lost the ability to have another child. Educate yourself and make sure that you are comfortable with the relative risks and benefits of D&C vs. misoprostol.

If you find the research difficult to read, I'm happy to answer questions (I do this stuff for a living).

Wow, that's way higher than what I was given. I was given one between the cheek/gum dose of 800 mcg. I do feel like I should've been given a second dose (maybe a little lower). And I'll be very upset if not everything passed, because I think it was working, just probably not enough.

But I feel like my doctor was just doing the cytotec to appease me. And now they're saying that, even though I took it last weekend, I should come in at the latest next week to see if it worked. I just feel like I'm being set up for a D&C, even though I was very clear about only wanting to do that as a last resort.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

But again, I'm curious to hear what you think is the correct way to use the cytotec.

http://www.misoprostol.org/File/guidelines.php

For missed miscarriage, the guidelines supported by clinical studies are:
- 800mcg vaginally 3-hrly (max x2) or sublingual 600mcg 3-hourly (max x2)
- Give 2 doses and leave to work for 1-2 weeks (unless heavy bleeding or infection)

I often hear of dosages that are two low, or are not repeated, or (most common) not given enough time to work.

I am not asking anyone to trust a stranger on the internet rather than their own doctor. I am urging women to do their own research, to learn about global standards and the long history of the safe use of misoprostol, and not to assume that every reproductive endocrinologist/gynecologist/obgyn is up to date on the research about the prevalence of Asherman's and the safe use of misoprostol/cytotec. Because I can assure you: they are not.

70% or so of women will sail through a D&C with absolutely no problems. But that's cold comfort if you're part of the 30%.

Please, please educate yourself. I didn't and I lost the ability to have another child. Educate yourself and make sure that you are comfortable with the relative risks and benefits of D&C vs. misoprostol.

If you find the research difficult to read, I'm happy to answer questions (I do this stuff for a living).

I call bs on your 30 percent statistic, particularly for women in the US going to a high end doctor/hospital. I think you have your own personal agenda.

Different PP. I have absolutely no agenda, except that I think my last D&C caused problems. I don't know for sure because my doctor wouldn't even let me get the saline ultrasound to check.

And therein lies the rub, it is really difficult to know how many women have problems. Not to mention, I'm sure there are a range of problems, not all of them necessarily permanent. I think the D&C stripped my lining too much. Over time, I'm sure it will build back up. But I'm not young, so time is of the essence.

I also think that they really resist doing follow up, like the saline ultrasound to see if there are issues. When I expressed concerns, they were pooh-poohed. A saline ultrasound isn't that complicated a procedure, and I don't understand why my doctor was so hesitant to do it.

As for the "high end doctor/hospital," the issue I have with this is that D&Cs, even in "high end" areas, are sometimes called "blind surgeries" because the doctor really has no way of seeing what he/she is doing unless they do it with an ultrasound. Ask around, and I'm sure you will be surprised to learn that a lot of "high end" doctors/hospitals don't do it with a sonogram. So it's difficult for them to see how much they are scraping. I think it's also why sometimes, even with a D&C, there are retained products.

This is the concern that I have with the procedure.

I don't have an agenda. I admit, the D&C was a lot easier than waiting it out. But I have a lot of concerns that the D&C has caused me problems I wouldn't have had otherwise.

Sometimes, though, there isn't much choice and things don't progress, and you have to get the D&C. I just think a lot of people are saying here that it's worth it to explore less invasive options first, but make sure that you ask questions b/c apparently, not all doctors use the cytotec the same way, and it appears as if some ways work better.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

But again, I'm curious to hear what you think is the correct way to use the cytotec.

http://www.misoprostol.org/File/guidelines.php

For missed miscarriage, the guidelines supported by clinical studies are:
- 800mcg vaginally 3-hrly (max x2) or sublingual 600mcg 3-hourly (max x2)
- Give 2 doses and leave to work for 1-2 weeks (unless heavy bleeding or infection)

I often hear of dosages that are two low, or are not repeated, or (most common) not given enough time to work.

I am not asking anyone to trust a stranger on the internet rather than their own doctor. I am urging women to do their own research, to learn about global standards and the long history of the safe use of misoprostol, and not to assume that every reproductive endocrinologist/gynecologist/obgyn is up to date on the research about the prevalence of Asherman's and the safe use of misoprostol/cytotec. Because I can assure you: they are not.

70% or so of women will sail through a D&C with absolutely no problems. But that's cold comfort if you're part of the 30%.

Please, please educate yourself. I didn't and I lost the ability to have another child. Educate yourself and make sure that you are comfortable with the relative risks and benefits of D&C vs. misoprostol.

If you find the research difficult to read, I'm happy to answer questions (I do this stuff for a living).

I call bs on your 30 percent statistic, particularly for women in the US going to a high end doctor/hospital. I think you have your own personal agenda.

Different PP. I have absolutely no agenda, except that I think my last D&C caused problems. I don't know for sure because my doctor wouldn't even let me get the saline ultrasound to check.

And therein lies the rub, it is really difficult to know how many women have problems. Not to mention, I'm sure there are a range of problems, not all of them necessarily permanent. I think the D&C stripped my lining too much. Over time, I'm sure it will build back up. But I'm not young, so time is of the essence.

I also think that they really resist doing follow up, like the saline ultrasound to see if there are issues. When I expressed concerns, they were pooh-poohed. A saline ultrasound isn't that complicated a procedure, and I don't understand why my doctor was so hesitant to do it.

As for the "high end doctor/hospital," the issue I have with this is that D&Cs, even in "high end" areas, are sometimes called "blind surgeries" because the doctor really has no way of seeing what he/she is doing unless they do it with an ultrasound. Ask around, and I'm sure you will be surprised to learn that a lot of "high end" doctors/hospitals don't do it with a sonogram. So it's difficult for them to see how much they are scraping. I think it's also why sometimes, even with a D&C, there are retained products.

This is the concern that I have with the procedure.

I don't have an agenda. I admit, the D&C was a lot easier than waiting it out. But I have a lot of concerns that the D&C has caused me problems I wouldn't have had otherwise.

Sometimes, though, there isn't much choice and things don't progress, and you have to get the D&C. I just think a lot of people are saying here that it's worth it to explore less invasive options first, but make sure that you ask questions b/c apparently, not all doctors use the cytotec the same way, and it appears as if some ways work better.

I'm just curious, without having a saline check or anything to confirm a problem what makes you believe it caused one? I have had 2 D&Cs and am TTC again with no luck yet.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

But again, I'm curious to hear what you think is the correct way to use the cytotec.

http://www.misoprostol.org/File/guidelines.php

For missed miscarriage, the guidelines supported by clinical studies are:
- 800mcg vaginally 3-hrly (max x2) or sublingual 600mcg 3-hourly (max x2)
- Give 2 doses and leave to work for 1-2 weeks (unless heavy bleeding or infection)

I often hear of dosages that are two low, or are not repeated, or (most common) not given enough time to work.

I am not asking anyone to trust a stranger on the internet rather than their own doctor. I am urging women to do their own research, to learn about global standards and the long history of the safe use of misoprostol, and not to assume that every reproductive endocrinologist/gynecologist/obgyn is up to date on the research about the prevalence of Asherman's and the safe use of misoprostol/cytotec. Because I can assure you: they are not.

70% or so of women will sail through a D&C with absolutely no problems. But that's cold comfort if you're part of the 30%.

Please, please educate yourself. I didn't and I lost the ability to have another child. Educate yourself and make sure that you are comfortable with the relative risks and benefits of D&C vs. misoprostol.

If you find the research difficult to read, I'm happy to answer questions (I do this stuff for a living).

I call bs on your 30 percent statistic, particularly for women in the US going to a high end doctor/hospital. I think you have your own personal agenda.

Different PP. I have absolutely no agenda, except that I think my last D&C caused problems. I don't know for sure because my doctor wouldn't even let me get the saline ultrasound to check.

And therein lies the rub, it is really difficult to know how many women have problems. Not to mention, I'm sure there are a range of problems, not all of them necessarily permanent. I think the D&C stripped my lining too much. Over time, I'm sure it will build back up. But I'm not young, so time is of the essence.

I also think that they really resist doing follow up, like the saline ultrasound to see if there are issues. When I expressed concerns, they were pooh-poohed. A saline ultrasound isn't that complicated a procedure, and I don't understand why my doctor was so hesitant to do it.

As for the "high end doctor/hospital," the issue I have with this is that D&Cs, even in "high end" areas, are sometimes called "blind surgeries" because the doctor really has no way of seeing what he/she is doing unless they do it with an ultrasound. Ask around, and I'm sure you will be surprised to learn that a lot of "high end" doctors/hospitals don't do it with a sonogram. So it's difficult for them to see how much they are scraping. I think it's also why sometimes, even with a D&C, there are retained products.

This is the concern that I have with the procedure.

I don't have an agenda. I admit, the D&C was a lot easier than waiting it out. But I have a lot of concerns that the D&C has caused me problems I wouldn't have had otherwise.

Sometimes, though, there isn't much choice and things don't progress, and you have to get the D&C. I just think a lot of people are saying here that it's worth it to explore less invasive options first, but make sure that you ask questions b/c apparently, not all doctors use the cytotec the same way, and it appears as if some ways work better.

I'm just curious, without having a saline check or anything to confirm a problem what makes you believe it caused one? I have had 2 D&Cs and am TTC again with no luck yet.

My periods were REALLY, REALLY light for 6 months after the D&C. I also had a weird pain in my side whenever I menstruated. Before the D&C, we got pregnant first time trying. After 6 months post D&C of trying, I got pregnant and miscarried.

I don't know if perhaps there's scarring (and that's the cause of the pain when menstruating) or if maybe it depleted my lining so much that my periods never really got normal again.

Again, I don't know. And it could just be paranoia. But a saline check would rule it out and put my mind at ease. But the doctor won't do it. That's part of the reason I don't want to get another D&C if I don't have to -- I don't want to worry that it caused a problem, especially if the doctor isn't going to take that seriously and do the thing that would rule out that concern. Does that make sense?

I'm not against D&Cs. But I do think that fertility (especially for late 30s women like myself) is a strange beast. Even women who get all kinds of testing done sometimes can't get any clear answers from doctors about what is causing the problem. Because in many instances, THEY DON'T KNOW. So my view is that as long as I'm going to still TTC, I'd rather try to avoid the procedure that is invasive, that has possible side effects/issues. Because even if it doesn't cause those issues, I'll still worry about them if I continue to have problems getting and staying pregnant.

As I wrote, it might be unavoidable to get the D&C. But while the D&C last time was definitely easier than waiting it out or using cytotec, the paranoia and worry I experienced for the 6 months following it were not worth it. That's what I'd like to avoid.

And, no, I'm not trying to scare anyone. Lots of women have D&Cs and then have no problem conceiving and staying pregnant.

[Anonymous]

I call bs on your 30 percent statistic, particularly for women in the US going to a high end doctor/hospital. I think you have your own personal agenda.

(I'm the PP you're replying to)

Totally okay! It's good to be skeptical of the statistics I'm quoting here. But don't stop there. Please look for yourself and decide whether or not you trust the source.

The wikipedia article on Asherman's syndrome is a convenient directory of links:
http://en.wikipedia.org/wiki/Asherman%27s_syndrome

The 30% I quoted was from

AS has a reported incidence of 25% of D&Cs performed 1–4 weeks post-partum,[9][10][17] up to 30.9% of D&Cs performed for missed miscarriages and 6.4% of D&Cs performed for incomplete miscarriages.[18] In another study, 40% of patients who underwent repeated D&C for retained products of conception after missed miscarriage or retained placenta developed AS.[19]

In the case of missed miscarriages, the time period between fetal demise and curettage may increase the likelihood of adhesion formation due to fibroblastic activity of the remaining tissue.[7][20]

The risk of AS also increases with the number of procedures: one study estimated the risk to be 16% after one D&C and 32% after 3 or more D&Cs.[21] However, a single curettage often underlies the condition.

Wikipedia by itself is not authoritative, but it is a handy way to find primary sources.

As to "high end doctor/hospital", it's unfortunately a myth that only badly-performed D&Cs cause Asherman's. It's more likely to be something intrinsic about some women's uteruses and how easily they develop scar tissue. Only using suction (as opposed to curettage) is also not a surefire way to avoid AS.

I guess I do have an "agenda" in that I hope by sharing my crappy experience I can help another woman to hang onto her fertility. Or do you think I'm being paid by big pharma to boost the sales of misoprostol? 800 mg (4 tablets) costs about $7. No one's getting rich off of it.

[Anonymous]

Please note that it's also easy to miss on a saline check. My first doctor didn't see it on the saline/SHSG. The second (at Shady Grove) caught it on the SHSG and sent me for a followup HSG, which confirmed it.

[Anonymous]

Anonymous wrote:

I call bs on your 30 percent statistic, particularly for women in the US going to a high end doctor/hospital. I think you have your own personal agenda.

(I'm the PP you're replying to)

Totally okay! It's good to be skeptical of the statistics I'm quoting here. But don't stop there. Please look for yourself and decide whether or not you trust the source.

The wikipedia article on Asherman's syndrome is a convenient directory of links:
http://en.wikipedia.org/wiki/Asherman%27s_syndrome

The 30% I quoted was from

AS has a reported incidence of 25% of D&Cs performed 1–4 weeks post-partum,[9][10][17] up to 30.9% of D&Cs performed for missed miscarriages and 6.4% of D&Cs performed for incomplete miscarriages.[18] In another study, 40% of patients who underwent repeated D&C for retained products of conception after missed miscarriage or retained placenta developed AS.[19]

In the case of missed miscarriages, the time period between fetal demise and curettage may increase the likelihood of adhesion formation due to fibroblastic activity of the remaining tissue.[7][20]

The risk of AS also increases with the number of procedures: one study estimated the risk to be 16% after one D&C and 32% after 3 or more D&Cs.[21] However, a single curettage often underlies the condition.

Wikipedia by itself is not authoritative, but it is a handy way to find primary sources.

As to "high end doctor/hospital", it's unfortunately a myth that only badly-performed D&Cs cause Asherman's. It's more likely to be something intrinsic about some women's uteruses and how easily they develop scar tissue. Only using suction (as opposed to curettage) is also not a surefire way to avoid AS.

I guess I do have an "agenda" in that I hope by sharing my crappy experience I can help another woman to hang onto her fertility. Or do you think I'm being paid by big pharma to boost the sales of misoprostol? 800 mg (4 tablets) costs about $7. No one's getting rich off of it.

13:48 here (the one trying to avoid a second D&C). I appreciate your information. And it seems consistent with things (from reliable sources) that I've read.

I flat out asked one OB in the practice I go to (I don't always get to see the same doctor) about Asherman's, and she told me that scarring is only an issue with people who have had many D&Cs (and she flat out said that by "many," she meant more than 5). But I really have a hard time believing that. I wonder if the issue is that they only CHECK for scarring after someone has had many D&Cs, so they don't know if it was the first one or the fourth that caused the scarring. Because my experience has been that they RESIST checking for scarring. I'm not sure why. (and if someone knows a valid reason, then please chime in.)

[Anonymous]

Anonymous wrote:

I call bs on your 30 percent statistic, particularly for women in the US going to a high end doctor/hospital. I think you have your own personal agenda.

(I'm the PP you're replying to)

Totally okay! It's good to be skeptical of the statistics I'm quoting here. But don't stop there. Please look for yourself and decide whether or not you trust the source.

The wikipedia article on Asherman's syndrome is a convenient directory of links:
http://en.wikipedia.org/wiki/Asherman%27s_syndrome

The 30% I quoted was from

AS has a reported incidence of 25% of D&Cs performed 1–4 weeks post-partum,[9][10][17] up to 30.9% of D&Cs performed for missed miscarriages and 6.4% of D&Cs performed for incomplete miscarriages.[18] In another study, 40% of patients who underwent repeated D&C for retained products of conception after missed miscarriage or retained placenta developed AS.[19]

In the case of missed miscarriages, the time period between fetal demise and curettage may increase the likelihood of adhesion formation due to fibroblastic activity of the remaining tissue.[7][20]

The risk of AS also increases with the number of procedures: one study estimated the risk to be 16% after one D&C and 32% after 3 or more D&Cs.[21] However, a single curettage often underlies the condition.

Wikipedia by itself is not authoritative, but it is a handy way to find primary sources.

As to "high end doctor/hospital", it's unfortunately a myth that only badly-performed D&Cs cause Asherman's. It's more likely to be something intrinsic about some women's uteruses and how easily they develop scar tissue. Only using suction (as opposed to curettage) is also not a surefire way to avoid AS.

I guess I do have an "agenda" in that I hope by sharing my crappy experience I can help another woman to hang onto her fertility. Or do you think I'm being paid by big pharma to boost the sales of misoprostol? 800 mg (4 tablets) costs about $7. No one's getting rich off of it.

You do realize that the particular cite for "up to 30 percent",is from an article that is more than 30 years old. Medicine has advanced quite a bit since 1982. Not to mention the fact we have no idea what the sample size was the article looked, etc. . .

I'm sorry that you suffered with its universally described elsewehre as a "rare" side effect of d&c. However, I do think you are scaring off others from a procedure that is much quicker and for many women, much less painful both emotionally and physically than the alternative with a bare minimum of medical fact and a lot of personal emotion. D&C also makes it far easier for the doctors to procure a tissue sample to determine the cause of miscarriage.

[Anonymous]

Anonymous wrote:
You do realize that the particular cite for "up to 30 percent",is from an article that is more than 30 years old. Medicine has advanced quite a bit since 1982. Not to mention the fact we have no idea what the sample size was the article looked, etc. . .

You'd think so, wouldn't you? But the fact is that D&Cs are now almost always performed exactly the same way as they were in 1982: "blind", by feel, scraping with a curette. The only ones I know who are performing guided D&Cs are Asherman's specialists.

I'm sorry that you suffered with its universally described elsewehre as a "rare" side effect of d&c. However, I do think you are scaring off others from a procedure that is much quicker and for many women, much less painful both emotionally and physically than the alternative with a bare minimum of medical fact and a lot of personal emotion. D&C also makes it far easier for the doctors to procure a tissue sample to determine the cause of miscarriage.

I am absolutely not telling anyone to trust my "personal emotion". My personal emotion is driving me to tell women to educate themselves about the very real and underreported risks of D&C. Look at the information out there and decide what risks you're comfortable with. Here are some more recent references:

2007: "In the present study, 37.6% of the women subjected to curettage following abortion had IUA [Intrauterine Adhesions]."
http://www.ncbi.nlm.nih.gov/pubmed/18094891

The is the only study I know of that followed women after D&C regardless of whether or not those women were trying to conceive, and that diagnosed them via the gold standard, a hysteroscopy.

2014: "In a recent meta-analysis, the pooled prevalence of IUA after miscarriage was found to be 19%, the vast majority of which developed after treatment with dilation and curettage (D & C)... In women with early pregnancy loss after in vitro fertilization (IVF), the prevalence of IUA has been reported as high as 38%."
http://www.ncbi.nlm.nih.gov/pubmed/24959821

It is absolutely true that if you want to test the tissue, you've gotta do a D&C. That's part of the cost-benefit calculation.

[Anonymous]

Anonymous wrote:

Anonymous wrote:
You do realize that the particular cite for "up to 30 percent",is from an article that is more than 30 years old. Medicine has advanced quite a bit since 1982. Not to mention the fact we have no idea what the sample size was the article looked, etc. . .

You'd think so, wouldn't you? But the fact is that D&Cs are now almost always performed exactly the same way as they were in 1982: "blind", by feel, scraping with a curette. The only ones I know who are performing guided D&Cs are Asherman's specialists.

I'm sorry that you suffered with its universally described elsewehre as a "rare" side effect of d&c. However, I do think you are scaring off others from a procedure that is much quicker and for many women, much less painful both emotionally and physically than the alternative with a bare minimum of medical fact and a lot of personal emotion. D&C also makes it far easier for the doctors to procure a tissue sample to determine the cause of miscarriage.

I am absolutely not telling anyone to trust my "personal emotion". My personal emotion is driving me to tell women to educate themselves about the very real and underreported risks of D&C. Look at the information out there and decide what risks you're comfortable with. Here are some more recent references:

2007: "In the present study, 37.6% of the women subjected to curettage following abortion had IUA [Intrauterine Adhesions]."
http://www.ncbi.nlm.nih.gov/pubmed/18094891

The is the only study I know of that followed women after D&C regardless of whether or not those women were trying to conceive, and that diagnosed them via the gold standard, a hysteroscopy.

2014: "In a recent meta-analysis, the pooled prevalence of IUA after miscarriage was found to be 19%, the vast majority of which developed after treatment with dilation and curettage (D & C)... In women with early pregnancy loss after in vitro fertilization (IVF), the prevalence of IUA has been reported as high as 38%."
http://www.ncbi.nlm.nih.gov/pubmed/24959821

It is absolutely true that if you want to test the tissue, you've gotta do a D&C. That's part of the cost-benefit calculation.

Well, but my doctor said that they don't test the tissue until it's your third miscarriage. I confirmed with my insurance, and they don't cover testing the tissue until the third miscarriage.

They didn't test the tissue from my first D&C and made it clear they won't test if I get a D&C this time (second miscarriage). So that's a moot point, unless you are willing to pay out of pocket for the testing and specifically request it.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
You do realize that the particular cite for "up to 30 percent",is from an article that is more than 30 years old. Medicine has advanced quite a bit since 1982. Not to mention the fact we have no idea what the sample size was the article looked, etc. . .

You'd think so, wouldn't you? But the fact is that D&Cs are now almost always performed exactly the same way as they were in 1982: "blind", by feel, scraping with a curette. The only ones I know who are performing guided D&Cs are Asherman's specialists.

I'm sorry that you suffered with its universally described elsewehre as a "rare" side effect of d&c. However, I do think you are scaring off others from a procedure that is much quicker and for many women, much less painful both emotionally and physically than the alternative with a bare minimum of medical fact and a lot of personal emotion. D&C also makes it far easier for the doctors to procure a tissue sample to determine the cause of miscarriage.

I am absolutely not telling anyone to trust my "personal emotion". My personal emotion is driving me to tell women to educate themselves about the very real and underreported risks of D&C. Look at the information out there and decide what risks you're comfortable with. Here are some more recent references:

2007: "In the present study, 37.6% of the women subjected to curettage following abortion had IUA [Intrauterine Adhesions]."
http://www.ncbi.nlm.nih.gov/pubmed/18094891

The is the only study I know of that followed women after D&C regardless of whether or not those women were trying to conceive, and that diagnosed them via the gold standard, a hysteroscopy.

2014: "In a recent meta-analysis, the pooled prevalence of IUA after miscarriage was found to be 19%, the vast majority of which developed after treatment with dilation and curettage (D & C)... In women with early pregnancy loss after in vitro fertilization (IVF), the prevalence of IUA has been reported as high as 38%."
http://www.ncbi.nlm.nih.gov/pubmed/24959821

It is absolutely true that if you want to test the tissue, you've gotta do a D&C. That's part of the cost-benefit calculation.

Well, but my doctor said that they don't test the tissue until it's your third miscarriage. I confirmed with my insurance, and they don't cover testing the tissue until the third miscarriage.

They didn't test the tissue from my first D&C and made it clear they won't test if I get a D&C this time (second miscarriage). So that's a moot point, unless you are willing to pay out of pocket for the testing and specifically request it.

My insurance paid after the second.

[Anonymous]

Anonymous wrote:

Anonymous wrote:
You do realize that the particular cite for "up to 30 percent",is from an article that is more than 30 years old. Medicine has advanced quite a bit since 1982. Not to mention the fact we have no idea what the sample size was the article looked, etc. . .

You'd think so, wouldn't you? But the fact is that D&Cs are now almost always performed exactly the same way as they were in 1982: "blind", by feel, scraping with a curette. The only ones I know who are performing guided D&Cs are Asherman's specialists.

I'm sorry that you suffered with its universally described elsewehre as a "rare" side effect of d&c. However, I do think you are scaring off others from a procedure that is much quicker and for many women, much less painful both emotionally and physically than the alternative with a bare minimum of medical fact and a lot of personal emotion. D&C also makes it far easier for the doctors to procure a tissue sample to determine the cause of miscarriage.

I am absolutely not telling anyone to trust my "personal emotion". My personal emotion is driving me to tell women to educate themselves about the very real and underreported risks of D&C. Look at the information out there and decide what risks you're comfortable with. Here are some more recent references:

2007: "In the present study, 37.6% of the women subjected to curettage following abortion had IUA [Intrauterine Adhesions]."
http://www.ncbi.nlm.nih.gov/pubmed/18094891

The is the only study I know of that followed women after D&C regardless of whether or not those women were trying to conceive, and that diagnosed them via the gold standard, a hysteroscopy.

2014: "In a recent meta-analysis, the pooled prevalence of IUA after miscarriage was found to be 19%, the vast majority of which developed after treatment with dilation and curettage (D & C)... In women with early pregnancy loss after in vitro fertilization (IVF), the prevalence of IUA has been reported as high as 38%."
http://www.ncbi.nlm.nih.gov/pubmed/24959821

It is absolutely true that if you want to test the tissue, you've gotta do a D&C. That's part of the cost-benefit calculation.

Neither of these abstracts discloses how many d&cs the patients has and the first is from a foreign country. If I had access to the full copies of each, I'm sure that I could find other ways they are not completely on point. My original point stands -- if this is a concern, talk to your doctor, not some random internet poster with a bias. For many women, the d&c is preferable to the drugs -- it was for me and I did both.