This post is going to have a lot of medical stuff, so if the word "uterus" freaks you out even a little, stop reading now. You have been warned.
Anyway, the doctor was very confident in his diagnosis and in our prognosis. First, looking at the MRI we had done, he said my uterus is not bicornuate, it's just septate. Which is good. Basically there's a range of possibilities from a normal uterus to two completely separate uteri and reproductive organs. Bicornuate is one step closer to normal, it's basically two uteri, but one cervix, vagina, etc. One step closer to normal is septate. It means the top of the uterus has come together, but there's still the point of the heart inside. You can see the septate and bicornuate uterus in the picture below, normal would be to the left of the picture and a double uterus would be to the right. Ignore the Asherman's syndrome in the middle, that doesn't apply to me.
The reason the radiologist who read my MRI the first time thought it was bicornuate was because on the MRI you can see the heart shape, which is present for both bicornuate and septate. What the fertility specialist was able to see the dark color (which means tissue or muscle) above the point.
The reason this is good is because with a bicornuate uterus, there is nothing that can be done. Surgery would cause too much scar tissue, and a baby cannot implant on scar tissue. With a septate uterus, they can do surgery to cut out the heart point. There is a risk of scar tissue, but not nearly as much with a bicornuate.
For the surgery I'll be put under (hallelujah) there will be one scope with scissors and a camera inserted up the vagina and one scope with a camera and dye inserted through my belly button. I guess the scope through the belly button is so small they don't even have to sew it, they just put tape on it. They fill the uterus with water to expand it and then when they're finished, they fill a balloon with water and insert it into the uterus for about a week. Doesn't that sound fun? That way the top of the uterus doesn't heal together and cause scar tissue.
While I'm out, they'll use the scope through my belly button to inject dye in the uterus and make sure it flows out through the fallopian tubes like it should. It's a test they would have done anyway, and it's pretty painful, so the doctor recommended they do it while I'm under anesthesia. I said the more painful things they do while I'm under instead of while I'm awake, the better. I don't like anesthesia though, I always cry when I'm coming out of it.
The surgery will probably be July/August, I'm still waiting on the scheduler to call me back. After that, I get put on hormones for two months. We have to wait at least a month after the surgery before it will be safe to get pregnant. Then we begin tackling the completely separate and unrelated issue #2, the PCOS.
So in a normal women, the brain sends Follicle Stimulating Hormone (FSH) to the ovaries which stimulates the follicles (creative name, huh) to mature an egg. Once the egg is mature it sends estrogen back to the brain, which causes the brain to stop sending FSH. The problem is my body has too much estrogen, so my brain stops sending the FSH before the egg is fully mature.
The first step will be chlomid, which is an anti-estrogen hormone. Hopefully my brain will then send enough FSH to mature an egg. If it doesn't, we'll raise the chlomid amounts until a certain point. After that, we'll start injections of FSH in addition to the chlomid. After that we stop the chlomid and do larger amounts of FSH. I really hope we don't get to that point because I absolutely hate needles. And these are shots you have to give yourself basically in the stomach. I can't even watch when I have blood taken, so this is not going to be fun. Hopefully the chlomid works and we don't even have to go there.
To be honest, I was hoping that the surgery I had as a teenager (a vaginal septum which is apparently a third unrelated issue) had already fixed the issue and the radiologist had just seen the remnants. And, ideally and somewhat unrealistically, I was hoping he would see that I was pregnant with the ultrasound. Obviously that didn't happen or this would be a very different post.
Stephen keeps reminding me that this was good news, and I suppose it is, I just had higher hopes. But the prognosis is good and hopefully we'll be pregnant by Christmas. And not with quintuplets (instances of multiples increase with the hormones....). From wondering if we'll ever have kids to Stephen's instant basketball team. And a reality tv show. :-)
