Tuesday, February 24, 2009

E-tegrity Test

Today I had an endometrial biopsy at my obgyn’s office. This was for the E-tegrity test.

The E-tegrity Test is used to determine how receptive the lining of the uterus is to implantation of a fertilized egg. The test checks for the presence of the Beta-3 integrin, a glue-like protein necessary for implantation to take place. The presence of Beta-3 integrin is strongly correlated with endometrial receptivity.

I felt this was necessary as out of 8 embryos transferred over 3 IVFs, nothing has ever implanted. There is a good chance that my uterine receptivity was affected by my astronomical e2 levels while on stims, but that is just a hopeful maybe. I have not been able to move forward with the next step, whatever that is, because I don’t trust my body to accept implantation. I thought this was a good start to determine if I do have implantation issues.

This test is performed 7-10 days after a positive opk. For me, it was 8 days post +opk and 7dpo.

So now for the details… if you are about to do this test, you may want to refrain from reading this.

The Nurse took me back to the room and we filled out all the paperwork. She told me that this test should be a piece of cake for me after all I’ve had done, and that I’ll just feel a little bit of cramping. She said it would be easier than the HSG. This gave me a lot of peace and so I sat there calmly waiting on the doctor.

The doctor came in and said she has had an endometrial biopsy before and I’ll feel an intense cramp. Ok, this sounded a little more scary than how the nurse described it, but it didn’t have time to sink in. I asked if she would numb me first but she said the injection would hurt more than the procedure.

She inserted a speculum and cleansed my cervix with iodine. She asked me to cough while she clamped my cervix. This pinched a little, but not too bad. She threaded a long hollow tube through my cervix and into my uterus. Still not too bad. She then pulls back on the plunger attached to the tube. This suctions the uterine tissue into the hollow tube. I yelped in pain. She then twists the tube as she continues to pull on the plunger which fills the tube with a spiral of your lining. I continued to literally yell out in pain. It was intense all right, but definitely not quick which significantly contributed to the pain.

After she was finished, she had me lay there for 10 mins. I was cramping pretty bad. The cramping subsided after about 15 mins.

The doctor and nurse admired the sample and talked about what a great sample it was. I sure hope so, I felt like she took my entire uterus. The nurse showed me my sample and it was quite a bit, so maybe my experience was much more painful than someone who had just a little removed. I can handle intense pain that is quick, but it is excruciating when it seems to keep going and going.

I have to be honest, this was the worst pain I have ever experienced in my entire life. If you have plans of doing this test, please insist on being numbed. I took 400mg of Ibuprofen 1 hr prior and it did nothing for me. Others have referred to this biopsy as uterine torture and there is no better label.

Many compare this test to the HSG and Hysteroscopy. I've had all 3 done now. In my experience, they were all painful. The Hysteroscopy fills your uterus with CO2 gas while the doctor views the inside... intense cramping, but quick and manageable. The HSG inserts a balloon into your uterus and then forces dye through... painful, but fairly quick. I could do both of these again if I had to. Then the biopsy, rips a chunk of tissue out... I will never do this test again without being thoroughly numbed or completely knocked out.

The doctor said she would get me a complimentary pad, I said I seem to be getting a lot of those lately. I put the pad on and good God, this thing practically went from my belly button to the top of my crack. I waddled out of there. I surprisingly had very little spotting, so I hopped off that saddle and went with a panty liner, ahhhh… I can walk again.

I headed to FedEx to drop off my specimen including a check for $475 for just the lab part of this procedure, yikes! But before I mailed it off, I snapped a photo of it.

Do you think they got enough??? I’m thinking about asking for my money back so I can go put a down payment on new uterus.


  1. Ouch and a big wince for you! Mine wasn't that bad but then when I looked at the sample my RE got, it was a small sample compared to yours. So sorry it was torture. I chuckled over your comments about the complimentary pad - don't they know about the super thin pads these days?? Anyway, glad it's over and done with. My results from the Beta 3 test came back quickly (2 weeks I think) so hopefully you'll have an answer soon.

  2. Um, wow. I know a bunch of women now who have had this test and I will say that each person's experience is different. Yours sounds terrible! I am so glad it is over for you and you will learn something, hopefully.

    I did hear that Dr. Schoolcraft commented to someone that maybe CGH and DE seem to work so well b/c it is a FET instead of fresh so that they body is better prepped. Maybe that is something to try (I am!).

    I'll be curious about your results too! now, take care of yourself! Do something nice for yourself...maybe a glass of wine or chocolate or something:-)

  3. Oh Lordy....I started cramping just reading about your experience. You poor thing:0( Thank GOD that's over with. Giving birth should be a piece of cake for you now...LOL!!

    Holy Moses on the sample....I hope they left some uterus in there...LOL! I hope everything comes back fine and that it is the E2 thing...that should be easy to remedy with some tweaking:-)

  4. Oh Jill, my heart broke when I read your comment on my blog and how different your experience was from mine. I'm ticked off at your doctor for not injecting your cervix. The injection is barely felt, a teeeeeeeny tiny pinch and some warmth (probably the Novocaine flowing). A breeze! And the only uncomfortable part (and I do mean uncomfortable, not painful) was the next 10 seconds with the back and forth of the pipelle stick. I just breathed and my doctor counted with me. My vial looked like yours in terms of biopsy quantity and I also barely had a spot of blood but, luckily, it was totally pain free!

    (aside from the needle to the cervix, I had 4 Advils, 2 Midols and 1 Ativan/Xanax - I'm sure that didn't hurt ;)

    But you know what, the good thing is you did it and it's over and now you'll get some much-needed information that'll give you direction.

    You're a brave girl for even doing the test (I almost chickened out a half dozen times!). :)

  5. Awww, Jill, I feel so bad for you. The first time I had one of these done it hurt like this. The second time my OB used Novacain and I hardly felt the injection. I feel so bad for you because I know that intense pain and it is not fun. Hopefully you will never need to have this done again, but if you do, insist on Novacain or something else stronger. My HSG and hysteroscopy were a breeze, but this endo biopsy hurts like h*ll.

    Take it easy tonight and I hope you are feeling better!

  6. Between you, me and Sky...we all had our biopsy done yesterday. I am sorry you had so much pain. I did too. I took 2 pain pills and a valium beforehand. I am quite jealous that you are doing the
    e-tegrity test. My RE practically laughed at me. I think it is completely worth it. I can't wait to hear your results and follow your blog.

  7. Hi Jill! Thanks for your comment on my blog. To answer your question, my test came back positive for the protein so it is present in the lining of my uterus. I still requested this test though even though I have had one chem and one PG (ending in m/c) because, like you, I wanted to rule out every possibility. If the protein was low than I thought it may have explained things but it checked out okay so that is not the reason for me. GL with your results!

  8. Yikes, I skipped the biopsy and went for the treatment--two months of depot lupron to get the lining to completely regenerate. Of course, I, too wonder about super high E2 and uterine receptivity. It's all so much to figure out sometimes!
    That picture gave me the heebie jeebies!

  9. Ouch!! That sounds PAINFUL!!

    I hope all of it is worth it in the end. I've never had this test (and it may be the only test I haven't had!)

    Good luck with the results. The picture was WOW :-) and yeah, I think they got enough!

  10. Jill, That sounds so awful! Thank God it is now over. I'm sure they will do a great analysis with your sample. They sure took a lot of you!

  11. I'm so sorry it was so painful! Great pic ;-). Here's hoping for great results and peace of mind.

  12. Jill, I had this lovely test done, too. Last August after my one-day at CCRM. I totally agree, it was the worst pain EVER. OMG. Hopefully it will come back normal for you. Congrats on going through with it! Luckily you didn't know before what is was going to be like!

  13. Ouch! Take care of yourself and try to relax. Wine and chocolate does sound good!

  14. Can't relate to your biopsy experience since I haven't experienced that, but I'm so sorry you had to endure that without some type of numbing or drugs. As advanced as technology is you would think some Gynecologist would come out of the dark ages. Hope you're feeling better today. Will be praying for a perfect results from your test. Looking forward to seeing you in 3 weeks.

    Love ya


  15. I very much feel your pain, Jill. Your description was very similar to mine - one of the most painful procedures I have ever done. I didn't have any numbing and didn't take any "prep" meds beforehand. I had mine done on my birthday of all days and posted a picture of Freddy Krueger because that is what it felt like.....

    I'm so glad it is over and done for you. Take care and treat yourself to something good......(read something chocolate)

  16. Jill WOW. I started to read this before I left the house yesterday for my endometrial biopsy - thanks for the warning, I'm glad I stopped!! In the end I was under a light general anaesthetic and the gynae also did a hysteroscopy. He said I'd beautiful lining - it's the only compliment I ever, ever get on the fertility front and I take it baby - or mebbe not, then it's down to my eggs. Am getting the integrin-B test done in the US (I'm from Ireland) and whatever biopsy test they do here also. I hope you're feeling a lot better today, it really does annoy me when you are given pain expectations and the reality is on a different scale - hello, you're an adult and would like to have some input to your pain relief??? Anyway GL with the results xxx

  17. Holy crap! Mine didn't really hurt at all but I had LOADS of drugs. So glad it is over for you now.

  18. OUCH! I am sore just reading your post! I'm sorry they didn't knock you out ~ I'll remember to ask for meds if I have to do this one! Hope the results bring good news for you!

  19. Owwwweee. I remember having that done. And you're right, the pain is intense, even if it's for like 20 seconds or so. It was the worse physically painful 20 seconds of my life at that time - before my severe OHSS. Nothing even comes close to what I felt - it was so bad that I asked to be put in a coma until it was over. But the endometrial biopsy is a really close second now. I hope you get your answer as to why none of the embryos transferred never implanted. I was in your shoes, going through all the transfers and not even a token beta number. How long will it take for the results?

  20. P.S. I tagged you in my post today!

  21. Thanks for popping in to see my E-tegrity results.

    I'm hoping your comes VERY SOON. Feel comfortable if you want to email/call your nurse on Tuesday or Wednesday for the results - if you used CalPath, they should definitely have them by then!

    And I'm keeping my fingers crossed for you that you get a positive back too.

    Isn't it funny that other than HPT's, betas and e-tegrity tests, positive test results are usually a bad thing! ;)

  22. Yeah, I shouldn't have read that. Crap. T minus 9 days!

    Also, I am really enjoying your blog - check out my site when you get a sec, I'd be happy to send you socks! http://www.fertilitysocks.org

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Thank you for your comment! Hugs, Kerry and Jill