Mike and I took a much needed vacation. For his birthday, a few weeks ago, I gave him tickets to see his beloved Buckeyes take on Penn State in Columbus, Ohio. We made a long weekend of it, since I am off on Fridays and got back LATE last night. It was amazing... exactly what we needed... to get AWAY!! We had an amazing time, and hubby especially loved seeing his Bucks win, by a landslide!
Now it's back to work... and back to reality.
We had a follow-up appointment the past Wednesday, the week of our trip. I decided to put it out of my mind until we got back. But like I said, now it's back to reality. So... Here is what we discovered. After having some shaky looking labs in the beginning, with a scary increased prolactin lab result... the repeat labs were all normal. Our doctor is chalking that up to the retained products that I had after our D&C surgery. His is cautious, however, and will watch my labs even closer in the future. In other news, I had no clotting factors or antibodies towards the pregnancy. Good news.
Now the bad news. I had a repeat sonohysterogram, the details of the first time we had this done at my OBGYN's office, including details about the procedure itself can be found here, or you can go to the post entitled "An Interesting Case" written in March. These new results came out abnormal. So... either the measurements were inaccurate the first time, or the tissue that they first thought could be a septum has enlarged and become more of a septum.
This is the shape of a normal uterus:
This is the shape that they first thought my uterus was:
This is how my uterus looks now (or did before but just got a good plane of measurement):
So what to do... ... ...
My septum is a little over 1cm in measurement. By radiological definition a septum can only be called a septum if it is at least 1cm. My doctor says, that by itself, this is not too impressive. He likely would have gone on with the first IVF procedure even if he had known this from the beginning. Now that he has seen me pregnant, however, he thinks that it needs to be surgically removed.
Here is the problem with a septum: it is composed of fibrous tissue. Fibrous tissue does not have the normal extensive blood supply that the rest of the uterus has running through it. When you get pregnant and the egg implants, you cannot control what wall of the uterus that the egg implants into. So if the egg implants into the fibrous part of the uterus, after the placenta is forming (which is around the time of our loss) it cannot get enough blood supply and will die... and there's nothing that can be done. This is what our doctor thinks happened. You can see where a placenta will form by visualized where the yolk sac is located in the gestational sac, and little baby b... that yolk sac was in the area right along the area where the septum begins. Baby A... completely at the septum (we will never know if this is why baby A stopped developing or if there was some other abnormality) but it is very likely that this is what happened with our little butterbean (baby b). Had either baby attached to any of the healthy walls, this may not have ended in miscarriage. But that is only for God to know. He is the only one with any true answers... we can just give the best guesses that our scientific minds can wrap their ideas around.
Surgery here I come. It will be on November 8th, which is a Friday, my off day. It will be done on an outpatient basis at East Memphis Surgery Center. I'm nervous about it, but know that I will be in good hands. This is the center that all of my procedures have been done at so I know the staff is awesome!! I also will not have any abdominal incisions, it will be done via hysteroscopy.
Hysteroscopy is preformed by inserting a flexible lighted tube into the vagina, through the cervix and into the uterine cavity. I will be under general anesthesia (asleep) for the procedure. My uterus will then be inflated with either saline or gas for better visualization of the septum. Then they will slowly cut away the fibrous tissue until they get to the normal tissue,and ultimately will give me a normal shaped uterine cavity. There is the possibility that a laparoscopy will be preformed at the same time if there are any complications. (A small incision is made into the abdominal cavity with an inserted lit tube to visualize the outside of my pelvic structures). The recovery will be similar to a D&C recovery... several weeks of bleeding and cramps, the worst of which will be the first few days after the procedure. I hope to be able to return to work the following Monday after the surgery. Please pray for that.
The hope is that, with the septum removed, I will be able to have a normal pregnancy. Now that I have had recurrent miscarriages... I feel like this is the right thing to do.
We ask for your prayer during this time for a successful surgery and a fast recovery, and that it may increase our future success!
God has led us so far in this journey... we know that He will be with us through every moment of this! Thank you for letting us share the good and bad with you.
"The joy of the Lord is my strength!" Nehemiah 8:10______________________________________________________
Please feel free to come with us with any questions you may have... and if you find yourself in our shoes... we would be HONORED to pray with you and for you! We can be reached any time at firstname.lastname@example.org