Before a transfer

After speaking to my doctor today, we decided to nix the prednisone and lovenox for the next transfer. It was an easy decision. In my mind, it did more harm than good even though we'll never really know for sure.

He also confirmed that he recommends an updated HSG since the last one is 3 years old and there was miscarriage in the meantime, so I scheduled it for next week.

Now for the complicated decision: whether or not to do a hysteroscopy before a transfer. It would be under anesthesia. Not only so that they can get better pictures but also if there's actually something there they can remove it right then and there. I would have to take a day off and then there's the recovery. It would also mean delaying a transfer by a cycle because it irritates the lining too much. I asked if that's basically an endo scratch and the doc answered that it's way more irritating plus there's water that goes into the tubes plus risk of infection - long story short he wouldn't do a transfer the same cycle. He doesn't feel strongly that it's necessary. He said it was up to me if I wanted to feel like I'm leaving "no stone unturned" before another transfer. On a scale of 1-10, 10 being that it was absolutely necessary, he said he'd rank it as a 4. 

On one hand I really don't want to leave any stone unturned, especially when it comes to transferring embryos of which we have precious few. I also remember our second opinion doctor recommended it, but then again some docs do just because it's a profitable procedure that gets them interesting data. On the other hand it's surgery. It's not necessary, I'd be opting in. So I'm trying to use logic. The reason we did the ERA procedures is because it was unpleasant but I knew I wouldn't stop thinking about whether we're transferring on the wrong day if we didn't do them. It wasn't an easy decision but it was justified when we discovered we did indeed need an additional day of progesterone to get a "receptive" lining.

I don't think the decision here is as simple. Putting aside the fact that we'd be transferring a month later, which I hate but am willing to swallow, I'm worried about doing more harm than good. Obviously if they find something and remove it then I'll feel wonderful and vindicated. But there's a slim chance they feel there's anything there to find. The risks are pretty high: a tear in the uterus? Infection? Who knows what else. The month wait would be the least of my problems.

My gut instinct is to reject this procedure. Logic is trying to convince me otherwise because if the transfer fails this is where my mind will go -- regret that we didn't take this step before transferring. We have a bit of time to decide so I know which thought will be permanently set up in my mind for the next few weeks.

What would you do?