Just got back from my hysteroscopy.
How "mild" is it? I have also been told I probably have a septum, although the RE who was filling in for my RE at the time of the sonohystogram said it appears to be a large one. There is a group on yahoo dedicated to women who have had that diagnosis. I can find the link for you, I posted it it an earlier thread. So, what I have to say here is just my 2 cents from my experience.
A septum in and of itself can definitely cause m/c and early deliveries. It is totally fixable. Now, the debate seems to be with your doctor if this is the route for you, I'm guessing because it is mild? You could go to a different RE for a second opinion, and if you have any pictures from the hysteroscopy you could have that RE review them.
After my m/c and being told that I might have a septum I did research and joined the yahoo group. I decided to have a consult with an RE and for me he recommended surgery. He stressed to me that with a septum the m/c risk is about 70% but with surgery it drops to 30%. Now, that said, there are women who have a septum and have healthy pregnancies and all that. I believe you would be among that group since you do have DS. How does that affect your risk for your next pg? I don't have an answer there.
Sometimes the surgeon is not able to resect the whole septum the first time. If there is a septum remaining that is <1/3 of the uterine cavity the thought is that it can stay there without causing major trouble. I don't know if yours is this small now. If it is maybe the doctor is thinking that it won't matter?
If you are the type who believes knowledge is power then I would do a google scholar search for mild uterine septum and read through the articles. Perhaps that will help you reach a decision.
For me, I am glad to have a probable reason for my m/c and I have decided I don't want to risk having another one. I will be having the surgery. I decided this before hearing that it was probably a large septum to boot. I realize that our situations are not completely the same.
Thanks so much for your post.
Hey Aryn - I am post-op for my uterine septum. During my last pregnancy/loss we discovered the uterine anomaly (originally thought to be bicornuate). I was officially diagnosed with a moderate septum on March 17th. I was told at that time that I had an 80% chance of mc with each pregnancy and almost 100% of preterm labor/delivery. If I opted for resection of the septum, my odds would just about reverse (80% chance of healthy pregnancy/20% chance of miscarriage - which is close to normal). There are several reasons that a septum can cause miscarriage, but I'm sure that your dr went over them with you. The two that stuck out for me were that a) if implantation occurred ON the septum, there wouldn't be enough blood flow there to adequately nurture the growing baby and b) that as the baby grows there will not be enough room and the uterus will not grow and stretch with the growing baby. I opted for surgery.
I was put on BC pills to be "regulated" prior to the procedure and I had the procedure on April 9th. During the procedure they discovered that there was more tissue present than originally thought and my septum was more severe. On April 19 I went in for F/U to be sure that they had removed all/enough of the tissue and they felt that they had. They wanted me to stay on b/c for another month while everything healed, but due to my Factor V Leiden and the clot risks, I didn't feel it was safe or necessary.
On May 7th, I returned to my regular (High-risk, MFM) OB and was given the green light to try again.
I am now post-op and just got my BFP. I know I mentioned when I joined this board that conceiving wasn't necessarily our issue, that staying pregnant was and I feel that since my procedure I have a much greater chance of maintaining a healthy pregnancy.
Not saying do it, that is between you, DH and your doctor, but I definitely know how much more positive and comfortable that I feel now being pregnant after having the procedure.
If i can help with any questions about the procedure, what to expect, etc please let me know :)
Hi Lydia - I'm sorry that when we "talked" about your septum I didn't have all of the same details regarding dates and timing that I provided Aryn, but it has only been since the "recent developments in my situation" that I have been pulling all of the past pg related documents.
Have you scheduled your procedure yet? Please let me know how it goes; I am keeping fingers crossed for you that it goes well and you get your sticky BFP soon after!
I'm not exactly sure yet when I'll be having my surgery. I have a follow-up with my RE next week to discuss the sonohystogram results and then my file will be forwarded to scheduling. They should be able to let me know within that week. Well, that's what I was told last time.
I do know that the RE wants me to take BCP (monophasic) for 6 weeks before he'll do surgery. Different doctors have different protocols. I don't know if your RE would want you to do this or not, it doesn't sound like it. So, I will start week 3 this weekend. The end of week 6 is around the second week in September. I don't know if surgery would be during week 6 or 7.
Yes, I was totally floored when I was told possible septum. I can't tell you that I was completely in the right frame of mind since they also told me at the same time that I would probably m/c. Nice day, huh?
It did take me some time to decide on the surgery, so don't feel bad if you can't decide today. DH & I just weren't comfortable resuming TTC without more knowledge and we're very glad we went to the RE.
I'm not relishing the idea of surgery either, but if that's what I need to do to have a successful pg then I will do it. In terms of losing time...My BFP was 4/1 and I was told 4/21 that I would probably m/c. It didn't happen until 5/30 (natural, at what was technically, I guess, 12w5d). Then the OB said to wait at least one cycle to TTC (she didn't think it would be a problem and I didn't need to look in it further; note OB is not an expert on septums). I think with a D&C you have to wait longer. My next cycle started 6/30. That's what, about 3-4 months not TTC. With the surgery, I'll be on BCP for 6 weeks and probably will have to wait 1-2 cycles to resume TTC. Maybe since yours is mild you'd only have to wait 1 cycle before getting back to TTC. It's not that bad and it should result in a happier ending.
You might only be out for 2 cycles, this next one and then the one after surgery.
Best of luck to you!
Thanks for sharing your experience.
Aryn - If it were me, I would go ahead and try this month. You know from previous experience that you can have a healthy pregnancy. By the doctor saying "mild" to not even knowing if that's what it is, I wouldn't waste what could be "your cycle." At least if you do get your BFP this cycle you will know going into it that you have the septum(?) and when it gets closer to term, they may have to monitor you closer and deliver earlier. Now, especially at a good hospital, a pre-mature delivery, while not ideal, is not the worst thing, and is really very manageable.
I went to see an IF specialist at Southeastern Fertility which is the best Fertility doctor in the state of SC for the diagnosis and the surgery. He is the one who provided the "statistics" that I passed on to you.
Again, my septum was moderate to severe. After 2 late term losses I knew that that was a major contributing factor, and in my head there wasn't an option not to have the procedure. And with my situation forfeiting 2 months for 80% chance at a full term healthy pregnancy wasn't a problem for us. It meant more to know that when we were able to try again we would have such a greater chance of a baby in the end than trying in those 2 months for another loss.
This is all just my opinion and my experience. I know that your situation isn't exactly the same. And, Like Lydia suggested, a second opinion can't hurt.
I wish you the best of luck for this cycle, with the decision that you are now facing and for your future TTC journey. Please let me know if I can help any more.
(PS. I know that you are coming to Charleston Labor day weekend, and while that is still far out, I could recommend a great doctor here in town that could take a look at it for ya ;))
I think I may have been a little caught up in my story there. Sorry.
So, bottom line, I think you need to do whatever is going to give you good sleep at night, KWIM? I wish your RE had given you more to go on.
Like I said, maybe your RE is thinking you may not need surgery since it's "mild". It sounds like your RE was saying it's very close to arcuate (? spelling) and hard to tell for sure. Arcuate is a normal variation and does not need surgery.
Was the yahoo group blog helpful?
I wish I had *the* answer for you. Please know that I support you no matter what you do with this difficult decision.
I am thinking the same thing.
Lydia - yes!