I went to bed feeling confident that I would go ahead and try and get pregnant again. I would focus on my diet, take baby aspirin and progesterone and hope for the best. I seriously thought about the fact that with 6 weeks of Lupron before and 8 weeks of post-op recovery, I could have gotten pregnant and known if I was going to miscarry by then....who the hell has to think that way? Me.....The doctor looked at the radiology HSG images and actually told me where he would like to see my uterus look....then when he did the dildo-cam, he retracted what he said a bit and told me this was very small and very unlikely the issue. 80% of a good uterus is short of fantastic but doable....
But I want 100%. I want the nest I know I am supposed to have for my little one. I do not want to have anything that I can look at and worry about with the next pregnancy. having a septate, no matter how small, is worrying the bleep out of me.
I woke up this morning with a serious feeling of panic, an awful feeling spread so quickly over my body the second I thought of getting pregnant again. How could I even think of getting pregnant again, knowing what I know and that there may be a slight chance that I could improve the environment of my uterus???
Needless to say, I have found way more questions for my doctor. I have gone back and forth feeling crazy for even thinking of going back into my uterus to fix something, something potentially minor....to feeling crazy for just assuming and hoping my uterus is ready for a baby.
My plan is to meet with my RE one more time to really look over the radiology pictures and to have a set of questions for him that may help me make this decision. I also set a message for my regular OB to look over my files and images and give me her opinion on pregnancies and septums. That is the least I can do. That way I feel like I have covered my bases and can make a more informed decision. I just do not want to go through another miscarriage again and the material I am reading in books and articles really all say the same thing: that a septate uterus is a huge contributer to recurrent miscarriage. Just because you have a uterine septum does not indicate you should automatically have surgery for it, but with a history of recurrent miscarriages, it may be advantageous.
I have to make a list of all of my questions for him. Here are a few:
1. What is the typical cut-off for surgery for a septate? I have read that a complete septate has a live birth rate of only 10%, how is 8mm compared to complete? Is complete like 5cm or something?
2. Is the risk of the hysteroscopy any more than a D&C? Because if I miscarry again, I would then be looking at both a hysteroscopy and a D&C.
3. If I were to get pregnant again and miscarry again, would this surgery be the obvious step to take (if genetics of the baby came back normal)?
4. If I were to get pregnant again without the fix and it was successful, does the place the placenta and baby attached then become "unusable space"? If so what percentage of my uterus would then be unusable, since I will begin with 20%.
5. If I were to become pregnant again, early on would an ultrasound indicate whether the embryo and then the placenta were attached to the septum?
6. Does the septum grow and stretch like the rest of the uterus when pregnant?
7. If I do get pregnant again, this septate will always be an issue with each additional pregnancy right?
8. If I were to try again and take pregnant with the septum, and it did attach in the wrong place....would the progesterone I am taking make it stick around and potentially allow a pregnancy that should not have remained viable occur? (How f^cking morbid am I?)
9. Along with the miscarriage rate associated with uterine septums, what else is there that I will need to keep an eye on (placenta problems, uterine space, c-section b/c of breech)
10. I know he still thinks 2 miscarriages is a chance occurrence and three is the magic number to take action...but what about my history:
- I am only 29
- Mine and J's genes came back normal
- The genetics of the second m/c came back normal ( unlikely it was my tissue since there was a perfect sac they could have taken from)
- All immune and coagulation/clotting tests came back normal
- The second m/c had a heartbeat at 6w2d and then it was gone
- I have a freaking septate, something closely tied to miscarriages.
This sucks. This is a true test of my ability to balance the hope and belief that things will be okay with trying to pinpoint the particulars for why my losses happened and how to make sure I do not have another one. At this point, if you asked me what I am thinking....I keep imagining I will be the woman who has two children but it took 10 miscarriages to get them.
:(
Tuesday, February 19, 2008
My Plan
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11 comments:
Man, it sounds like you have a lot running through your mind right now. I haven't been in your shoes, so I can't give you any advice. I'm thinking of you and your situation though.
Same as Rachel. I have no advice to give, but I'm here. Supporting you.
You're on the L&F, right? I think you'll be getting some great advice and insight soon.
I have absolutely no advice but, I think your questions are good ones and right ones and often all we can do is start by asking the right questions.
I get the feeling that often Dr.s tend to gloss over the devastating effects that m/c's have on a woman and for them it may seem prudent to allow 3 or more to occur before action is taken, but for the woman the damage done by each successive loss is immeasurable.
My heart goes out to you and I am crossing everything in hopes that you get answers that make sense and help you feel at peace about what to do now. (BIG HUGS!)
All good questions Kate, I don't think your morbid at all. This is our life and this is how we think. No sugar coating. It's what you have to think about. I'm crossing my fingers for you...regardless of what decision you make...keep us posted.
I think your questions are fabulous. And I really, really hope you find answers soon. The worst is not knowing. Much luck!
It's so scary. Every part of you wants to get pregnant, but you're understandably concerned that you would just be harming yourself if you didn't take every opportunity to improve your chances of carrying to term.
I hope your RE can answer all your questions.
oh boy. That's a lot of questions. And I'm so happy that you wrote them all down and you are going to make sure you ask everyone involved.
I know my uterus issue wasn't your uterus issue, but I did have something to add. My ute started out at 30% sealed shut and definitely needed surgery. Then I had a 70% success, which again, my doc said I needed surgery. He said I could "cross my fingers" that if I got pregnant, I would stay pregnant, but that the remaining scar tissue is definitely a risk of miscarriage. What is that? 9% left, right? 70% of 30% is 21% of the original 30%. So I had 9% left.
We opted for surgery again. THEN, when I only had a teeny bit of tissue left that was "kissing", the doc said that we could try again, but if he was going to do IVF with me, he wouldn't proceed with my uterus in that condition.
This all leads to me with thinking your questions about "80%" normal are very valid. And I think that 20% is a very scary thing.
My heart is with you and I hope you can get some answers. I have to say all my surgeries sucked, but I'm glad my oven is in working condition now. Well, supposedly.
hey Meg, I just saw on Lost & Found there is a new blog http://www.newyearnewute.blogspot.com/ which is all about a girl with recurrent m/c and she ~just~ had surgery to remove her septum - maybe you guys can learn some info off of one another?
Good questions. I'm curious to read what your RE says when you meet.
Meg, I am glad you found me and the yahoo group. I replied to your comment there, but feel free to email me lellowg at gmail dot com.
Anyways, these are good questions. But, your RE needs to be well versed in MA's to really understand. So many of them put the 3 miscarriage limit on surgery and that is completely unnecessary!
If your RE doesnt answer these questions and make you feel comfortable, get a second opinion from someone who specializes.
On March 5th, I am having the surgery to remove my 1-2cm septum. In a 20 minute outpatient surgery, I am going to have a huge % increase in the ability to have a live birth.
Hang in there lady, I know its tough making these decisions. But take charge of your care and get answers that suit YOU, not just the doctor.
xox
g
Hi Meg, sorry I was traveling and am not seeing this until now. Sometimes getting an answer always bring up more questions and I am impressed with your list.
I think you should find someone who specializes in this issue. It sounds like folks have already pointed you in the right direction to get some more resources. No matter how scared you are, do not give up on your dream.
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