Anomaly

Anomoly.  Congenital.  Rare – in my case occurring in 0.1-0.5% of women or possibly as high as 10% in women with recurrent pregnancy loss[1].

On Monday I had a hysterosalpinogram (HSG) done to check the lining of my uterus for abnormalities potentially caused by a cesarean section in 2004.  My doctors and I are not finding good reasons for repeat pregnancy loss.  My lupus anticoagulant panel came back clean, and the only test left to do in my current OB’s mind is an ANA.

As a result of the HSG, I was diagnosed with uterus didelphys, one of several Mullerian Anomalies.  The OB is certain that this is the cause of my recurrent losses though still recommends the ANA blood draw.  He doesn’t think I need to proceed with a thrombophilia panel.  He didn’t offer any course of action for this issue, suggesting that we should just “keep trying.”  He was surprised that this hadn’t been diagnosed sooner.

Of course, being the curious person that I am, I performed internet searches for “double uterus,” “didelphic uterus,” and “uterus didelphys.”  I also chatted with an internet friend who put me in touch with a couple of other people who have been diagnosed with anomalies.  I have joined a yahoo group that deals specifically with these anomalies.  Even a couple of hours after the procedure, having looked at many pictures on the internet, I began to have doubts about my diagnosis.

I will obtain a copy of my HSG “picture” hopefully today from the radiology lab.  When I compare what I remember seeing on the screen at the hospital with what I see on the internet, I think it’s more likely that my uterus is bicornuate (heart shaped) and/or possibly contains an uterine septum.  A septum would be most problematic for maintaining a pregnancy because if the baby implants on the septum, it will not have enough vascular support to grow.  (This just breaks my heart.)

What next?  I am going to be in Denver for a couple of months studying vocology (vocal science).  (I need a calculator and to remember my college physics class from 1990, eek.) I am looking for a reproductive specialist there who will do a thorough investigation of immunological, endocrine, and structural causes for my losses.  It is possible that the immunological path has been exhausted, but with my mother’s history of autoimmune disease, I’m not so sure.  Endocrine/hormone issues haven’t been addressed to my satisfaction.  Neither OB group I have worked with in town believe in progesterone deficiency.

So, that’s my story in a nutshell for now.

[1] Müllerian duct anomalies are estimated to occur in 0.1-0.5% of women. The true prevalence is unknown because the anomalies usually are discovered in patients presenting with infertility. Some women carry babies to term with anomalies, so it could be more common, possibly as high as 3% of all women.  Sources: http://www.emedicine.com/Radio/topic738.htm; http://www.seattlefertility.com/treatmentOps_UterineAnomalies.htm

About these ads

6 responses to “Anomaly

  1. I’ve spent the better part of the day trying to find something to say.
    Something that doesn’t sound trite or …. ???
    I’m glad that you have some answers… and sad that you have some answers.
    okay, should have stuck with being at a loss for words.

  2. I am sorry for your losses and pain, and the searching for answers. I think it is great that you are seeking another doctor. I know a few women who have had repeat pregnancy losses, only because they became their own activates, did research, talked to lots of drs were they able to carry to full term. Good luck with the new dr… careful what you read on the internet… I truly believe you could search hang nail and find a doomsday report – ok maybe an exaggeration, but it is often doom and gloom in the medical area… good luck!

  3. My sister had 3 miscarriages before having two successful pregnancies. It was a very difficult time for her — not knowing if she would ever have children, not knowing what the problem was. She ended up having a septated uterus, which they repaired with laparoscopic surgery (removing the septum). There was also the possibility of her having low progesterone, so the same miscarriage specialist that diagnosed the problem put her on progesterone suppositories (which had to be compounded at the pharmacy) “just in case.”

    If you think the problem may be hormone-related, you may want to check out naprotechnology.com — a fellow childbirth instructor told me about the site for natural family planning, but they also deal with miscarriages and all sorts of female fertility issues. I’ve not checked it out extensively, but what I’ve read makes sense, and may give you more answers.

  4. I know you dont know me. I found your blog through a search. I have a class 2 abnormality (unicournate) and just wanted to let you know that it is possible to get pregnant with an abnormality. It did take me 2.5 years with my first daughter but I conceived her without medical intervention and since I have had another daugher, a m/c at 7 weeks and am now pregnant with a baby boy, all without medical intervention. I do have issues with PTL but we monitor it carefully and it looks like this time around I may make it full term! I hope that you have success soon!

  5. I also have uterus didelphys. There is good news….I have a healthy four year old son. We have been trying for another baby since he was a year old. We had a stillborn @ 30 weeks (unrelated to uterine anomaly) and we have had 4 miscarriages. I just had an hsg last week which revealed that the two uteruses are not connected, with the exception of what looks like a tunnel the size of a hair. So, they are communicating, but can still maintain a pregnancy. However, it is almost a guarantee that you will deliver prematurely. My son was delivered at 32 weeks. The left uterus is good, the right is not. The right is not elastic enough to maintain a pregnancy. We will be having surgery soon to remove the right tube so that we cannot get pregnant on that side – – all of the miscarriages have been on that side.

    **Note – I had to use vaginal progesterone suppositories with my son since my hormones were not sufficient. But, not with the stillborn. Should you become pregnant, they will need to do a blood test to check progesterone levels immediately.

  6. Thank you Tiffany for posting. I’m glad to know that women do have successful pregnancies (or at least the possibility of) with UD. I’ve actually discovered that I don’t have a mullerian anomaly. (HSG doesn’t always reveal what the exact abnormality is…)

    I also have insufficient hormones so will be doing HCG injections during the luteal phase followed by progesterone injections (and regular blood tests) once pregnancy is confirmed.

    I’m so sorry to read about your losses – I especially can’t imagine losing a babe at 30 weeks! Hugs!!

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s