Re: Ist meeting with RE - what do you guys think? UD

[Guest guest]

HI Brandee,

I think I missed your earlier posts, but are you actually having problems

conceiving, or are your problems with remaining pregnant?

I'm a UD - I've had two miscarriages (plus 1 healthy boy at term and now 27

wks with no. 2) but have never had a problem with conception. I believe the

research suggests that UD are no more likely to have problems ttc than

anyone else. If you have a history of infertility, Clomid/AI might be

advisable. But if your problem is miscarriage rather than fertility - why

would your RE doing trying to treat your supposed 'infertility'?

All my best wishes

Judith

> Hi! Just an update for everyone. I met with the RE yesterday and I

> thought he was awesome. We went over all of the history and so forth.

> It was just a consultation to see what road we're going on.

> Basically, I am doing some blood work and then after my next cycle he

> is going to do an endo biopsy on both sides of my uterus. I've had an

> HSG and an ultrasound already by other drs but yesterday the RE did a

> pelvic exam and identified my uterus as UD. He says it 's not the

> best case scenario but it's not the worst. After the bloodwork and

> biopsies, given that everything is good, we can start to TTC again.

> He said he will monitor me very closely to check the hormone levels

> and make sure everything is good there. Other than that it's still

> trial and error. He doesn't want to get too aggressive at this time

> but he did mention Clomid injections and possibly artificial insemm.

> I guess that's based on the test results. He said so much yesterday

> that it's hard to remember. He seems very positive about the whole

> thing and that's helpful... but he has the luxury of his experience

> to fall back on...we only have our own. What do you guys think of all

> of this and what do you think of Clomid injections? I've read some

> conflicting things such as it may contribute to cervical or ovarian

> cancers???? That's disturbing...but I also read that it's one of the

> best drugs out there. I'll have to wait and see if I even have to

> take that. I'm not having a problem getting pregnant...it's staying

> pregnant. Two early miscarriages since March. Thanks for the help and

> and the ears.

> Best of luck to everyone and lots of prayers!!

> Brandee

> 2 m/c 3/05 & 7/05

> TTC #1

>

>

>

>

> Share bookmarks: http://groups.yahoo.com/group/MullerianAnomalies/links/

>

> Share files:

> http://groups.yahoo.com/group/MullerianAnomalies/files/

>

> The Congenital Uterine Anomalies Home Page:

> http://www.wegrokit.com/uterineanomalies/

>

>

>

> es/

>

> The Congenital Uterine Anomalies Home Page:

> http://www.wegrokit.com/uterineanomalies/

>

>

>

>

>

>

>

>

[Guest guest]

Hi Judith,

Thanks for your response. I don;t know what he was saying exactly about Clomid.

I think he referenced that when he was speaking about whether or not both

uteruses were able to carry a child and he'd want to make sure the good side

ovulated enough...or something like that. It's not something he wants to do

right away...he may have been thinking further down the line if we run into

other problems. I don't assume that I have a problem getting pregnant. My DH and

I started trying last Nov/Dec. and got pg in March (m/c), waited 3 months like

my gyn asked and then tried in late June/early July and got pregnant, (#2 m/c).

Now we're with the RE and this is where we stand. I am happy to hear that you

carried full term. I know preterm is a possibility. I am just having a problem

staying pg. Both my m/c were very early. Were your m/c consecutive? Any advice

you have is most helpful and appreciated. Best wishes to you with #2. I'll keep

your family in my prayers. Thanks

Brandee

Judith Green jtg22@...> wrote:

HI Brandee,

I think I missed your earlier posts, but are you actually having problems

conceiving, or are your problems with remaining pregnant?

I'm a UD - I've had two miscarriages (plus 1 healthy boy at term and now 27

wks with no. 2) but have never had a problem with conception. I believe the

research suggests that UD are no more likely to have problems ttc than

anyone else. If you have a history of infertility, Clomid/AI might be

advisable. But if your problem is miscarriage rather than fertility - why

would your RE doing trying to treat your supposed 'infertility'?

All my best wishes

Judith

> Hi! Just an update for everyone. I met with the RE yesterday and I

> thought he was awesome. We went over all of the history and so forth.

> It was just a consultation to see what road we're going on.

> Basically, I am doing some blood work and then after my next cycle he

> is going to do an endo biopsy on both sides of my uterus. I've had an

> HSG and an ultrasound already by other drs but yesterday the RE did a

> pelvic exam and identified my uterus as UD. He says it 's not the

> best case scenario but it's not the worst. After the bloodwork and

> biopsies, given that everything is good, we can start to TTC again.

> He said he will monitor me very closely to check the hormone levels

> and make sure everything is good there. Other than that it's still

> trial and error. He doesn't want to get too aggressive at this time

> but he did mention Clomid injections and possibly artificial insemm.

> I guess that's based on the test results. He said so much yesterday

> that it's hard to remember. He seems very positive about the whole

> thing and that's helpful... but he has the luxury of his experience

> to fall back on...we only have our own. What do you guys think of all

> of this and what do you think of Clomid injections? I've read some

> conflicting things such as it may contribute to cervical or ovarian

> cancers???? That's disturbing...but I also read that it's one of the

> best drugs out there. I'll have to wait and see if I even have to

> take that. I'm not having a problem getting pregnant...it's staying

> pregnant. Two early miscarriages since March. Thanks for the help and

> and the ears.

> Best of luck to everyone and lots of prayers!!

> Brandee

> 2 m/c 3/05 & 7/05

> TTC #1

>

>

>

>

> Share bookmarks: http://groups.yahoo.com/group/MullerianAnomalies/links/

>

> Share files:

> http://groups.yahoo.com/group/MullerianAnomalies/files/

>

> The Congenital Uterine Anomalies Home Page:

> http://www.wegrokit.com/uterineanomalies/

>

>

>

> es/

>

> The Congenital Uterine Anomalies Home Page:

> http://www.wegrokit.com/uterineanomalies/

>

>

>

>

>

>

>

>

[Guest guest]

Brandee,

have your doc think twice before clomid and IUI. its

my understanding tho i may be wrong- you shouldnt

carry twins in a UD uterus- and clomid + IUI puts you

at risk for multiple pregnancy (and who wants to

endure " selective reduction. " ) if you have trouble TTC

you should ideally go straight to IVF with a single

embyro transfer.

best

heidi

[Guest guest]

Hey Heidi! Thanks for the info. I am not having trouble TTC...it's staying pg. I

don't know what mt dr was talking about with the Clomid. I think he was speaking

of options in the future...if we have to get more aggressive. I get lost

sometimes with the info...I can usually remember a conversation word for

word...I go to the dr, pay attention, get home and forget some of the

conversation. Right now I'm just doing blood work and endometrium biopsy in a

couple weeks. Hopefully we can start TTC again. And hopefully no more m/c.

Thanks

Brandee

2 m/c 3/05 & 7/05

Heidi Thermenos heidi_thermenos@...> wrote:

Brandee,

have your doc think twice before clomid and IUI. its

my understanding tho i may be wrong- you shouldnt

carry twins in a UD uterus- and clomid + IUI puts you

at risk for multiple pregnancy (and who wants to

endure " selective reduction. " ) if you have trouble TTC

you should ideally go straight to IVF with a single

embyro transfer.

best

heidi

Share bookmarks: http://groups.yahoo.com/group/MullerianAnomalies/links/

Share files:

http://groups.yahoo.com/group/MullerianAnomalies/files/

The Congenital Uterine Anomalies Home Page:

http://www.wegrokit.com/uterineanomalies/

es/

The Congenital Uterine Anomalies Home Page:

http://www.wegrokit.com/uterineanomalies/

[Guest guest]

Brandee,

Good luck and praying for no more miscarriages for

you. it is tough to pay attention at the doc when

theyre telling you info esp things that are upsetting.

this is why DHs should always be forced to attend

appointments if at all possible! ;o)

best of luck and good wishes,

Heidi

--- Brandee Manning bramanning@...> wrote:

> Hey Heidi! Thanks for the info. I am not having

> trouble TTC...it's staying pg. I don't know what mt

> dr was talking about with the Clomid. I think he was

> speaking of options in the future...if we have to

> get more aggressive. I get lost sometimes with the

> info...I can usually remember a conversation word

> for word...I go to the dr, pay attention, get home

> and forget some of the conversation. Right now I'm

> just doing blood work and endometrium biopsy in a

> couple weeks. Hopefully we can start TTC again. And

> hopefully no more m/c. Thanks

> Brandee

> 2 m/c 3/05 & 7/05

>

>

> Heidi Thermenos heidi_thermenos@...> wrote:

> Brandee,

> have your doc think twice before clomid and IUI. its

> my understanding tho i may be wrong- you shouldnt

> carry twins in a UD uterus- and clomid + IUI puts

> you

> at risk for multiple pregnancy (and who wants to

> endure " selective reduction. " ) if you have trouble

> TTC

> you should ideally go straight to IVF with a single

> embyro transfer.

> best

> heidi

>

>

>

> Share bookmarks:

>

http://groups.yahoo.com/group/MullerianAnomalies/links/

>

> Share files:

>

http://groups.yahoo.com/group/MullerianAnomalies/files/

>

> The Congenital Uterine Anomalies Home Page:

> http://www.wegrokit.com/uterineanomalies/

>

>

>

> es/

>

> The Congenital Uterine Anomalies Home Page:

> http://www.wegrokit.com/uterineanomalies/

>

>

>

>

>

>

>

>

[Guest guest]

Hi Brandee,

> I think he referenced that when he was speaking

> about whether or not both uteruses were able to carry a child and he'd

> want to make sure the good side ovulated enough...or something like that.

Hmmm, not sure about this. As I understand it, some women with UD have an

obviously more 'developed' uterus and an obviously more 'rudimentary'

uterus - this should be visible with investigation. In this case it makes

sense to try for the 'better' uterus - if you have a vaginal septum. For me

it's natural to have sex on the 'dominant' side of my vaginal septum

because that is more comfortable for me - and predictably that side also

has the more developed cervix/uterus. So, that's worked out well (though I

didn't plan it that way - I just did what felt right). Theoretically that

gave me a 'shot' at conception every other month, assuming that I ovulated

on alternating sides. But of course one doesn't know which ovary has

released an egg - so you could be having 'useless' sex. (As it happens my

husband has always been disappointed when I've got pregnant 'too quickly' -

since he appreciates 'trying' so much:-). It's also theoretically possible

(but not likely) for an egg from one ovary to 'migrate' to the other

fallopian tube (this is a danger for women with Unicornate Uterus +

rudimentary horn, because the rudimentary horn definitely can't carry a

pregnancy - but that's NOT a proven problem in UD, women canand have

carried on both sides). It's also possible to occasionally ovulate

naturally from both ovaries in a single cycle (that's how naturally

occuring non-identical twins are conceived) - though less common without

fertility drugs.

If you don't have a complete vaginal septum, you have no control over

which uterus might carry the pregnancy if you conceive naturally, since

semen will enter both uteri. I don't think you can really know the

capability of a uterus to carry a pregnancy to term until it's been tested

by a pregnancy that goes into the second trimester. It's a heartbreaking

process, but I don't see how a doc could be sure in advance that a uterus

couldn't carry a pregnancy to term or something close to term.

> I don't assume that

> I have a problem getting pregnant. My DH and I started trying last

> Nov/Dec. and got pg in March (m/c), waited 3 months like my gyn asked and

> then tried in late June/early July and got pregnant, (#2 m/c).

It's terrible about the miscarriages, but your fertility sounds just great.

I think the fertility in the general population in any single cycle is

about 16% - most couples take a while to get pregnant, but most(80-90%)

will be pregnant within a year. Based on your history, it looks like your

odds of getting pregnant again quickly are way better than average.

> Were your m/c consecutive?

No, I miscarried with my first and third pregnancies - both at around 8

weeks gestation. It feels really terrible at the time, and definitely made

me more distanced about subsequent early pregnancy (conciously trying to

remind myself to think 'I'm pregnant' rather than 'I'm having a baby' until

I'd got to 13 wks or so). However, miscarriage is such a common problem and

I didn't necessarily put it down to the UD. More stats, I'm afraid: about

20% of all confirmed pregnancies end in miscarriage, and some docs estimate

that the figure would go up to 30-40% of all conceptions, if the v. early

miscarriages in undetected pregnancies were included. Obviously, there can

be some specific reasons for recurrent early miscarriage, some to do with

having an MA (issues with implantation and blood supply to the placenta etc

- but this is more a problem for women with SU, I think) or for another

reason (genetic, immunological) - but if (God forbid) you were to have a

third consecutive miscarriage, you might be better off getting your doc to

investigate the causes of the m/c rather than trying to boost your

fertility.

As for the other hazards of pregnancy with UD? Well, there's probably not a

great deal you can do to prevent preterm labour if it's destined to happen

to you - though if you have a proven incompetent cervix cerlage may make a

difference. More important is making sure that the best interventions are

available if it does happen - drugs to promote lung maturity before birth,

the very best NICU care etc.. BUT - and this is important - the causes of

late miscarriage/preterm labour and birth are completely different from the

causes of early miscarriage. The fact that you've had early miscarriages

doesn't indicate any greater risk of late miscarriage or preterm labout.

With UD you have a higher chance of having a breech baby, and these days

that almost certainly means a c-section. But otherwise, you can have a

normal labour and birth.

Good luck with trying to conceive, and don't forget to have fun trying.

Judith

ps. Just scrolled down and looked at your earlier post again - why endo

biopsy? I know that some MAs (those caused by DES) have higher incidence of

cancers, but is this really necessary in your case? What are the biopsies

for? And you should try to confirm 100% that you are UD - I don't think a

pelvic exam, plus ultrasound is sufficient - gold standard would be

lap/hyst so they can see the shape inside and outside of the uterus/uteri.

It's a day surgery usually under general - though I guess it could be done

with regional anaesthesia, a bit painful afterwards (you'll feel like

you've been pumped full of air) but done with tiny fibre optics, so no real

invasive surgery.

[Guest guest]

Hi Judith,

Thanks for all the info. I do have a more dominant side and I do have a septum

(down to my cervices). He determined that I am UD from a past HSG, ultrasound

with a peri and the pelvic exam. He wasn't completely convinced until he did the

pelvic exam. He says with UD the cervixes are clearly separate not touching with

a possible septum in between making it look like two. And mine were clearly

separated. So much that he sais it looked as if from having sex the penis had

pushed the septum clearly to the other cervix, looking as if it is used less

often. Which is good I can assume. I do know that one side is way easier to get

to than the other. As far as both uteri being able to hold a pg...I've heard

conflicting statements on that. The last high risk peri I went to said that both

uteri look big and healthy. It's the best peri center in Atlanta and he seems to

know what he's talking about. I will definitely have to ask again about the

Clomid issues. I may be bringing up something he was

saying not to do. He is a very recommended RE and comes from some of the best

schools so I'll bring it up again. The endo biopsy is to check the lining of the

uterus. Maybe he's doing that because in both my m/c it was too early to see

what side the pg was in. I always m/c before the US. I think it's a

precautionary measure to make sure the lining is ok...just something else to

rule out. To see if the pgs have even had a chance to attach properly. If one

side is good and the other not then maybe we will have to focus on the good

side. Anyway, thanks for your help. I will keep you posted. I am very hopeful

after speaking with you and hearing your story. Especially that you've already

had a full term pg. I know this could be a long road ahead, but then again, it

could not be. I'm staying hopeful and positive until I reach that goal. And to

think, after the 1st baby I'm going to do this all over again for another baby.

If you think of anything else please let me know. Thanks again.

Brandee

" J.T. Green " jtg22@...> wrote

Hi Brandee,

> I think he referenced that when he was speaking

> about whether or not both uteruses were able to carry a child and he'd

> want to make sure the good side ovulated enough...or something like that.

Hmmm, not sure about this. As I understand it, some women with UD have an

obviously more 'developed' uterus and an obviously more 'rudimentary'

uterus - this should be visible with investigation. In this case it makes

sense to try for the 'better' uterus - if you have a vaginal septum. For me

it's natural to have sex on the 'dominant' side of my vaginal septum

because that is more comfortable for me - and predictably that side also

has the more developed cervix/uterus. So, that's worked out well (though I

didn't plan it that way - I just did what felt right). Theoretically that

gave me a 'shot' at conception every other month, assuming that I ovulated

on alternating sides. But of course one doesn't know which ovary has

released an egg - so you could be having 'useless' sex. (As it happens my

husband has always been disappointed when I've got pregnant 'too quickly' -

since he appreciates 'trying' so much:-). It's also theoretically possible

(but not likely) for an egg from one ovary to 'migrate' to the other

fallopian tube (this is a danger for women with Unicornate Uterus +

rudimentary horn, because the rudimentary horn definitely can't carry a

pregnancy - but that's NOT a proven problem in UD, women canand have

carried on both sides). It's also possible to occasionally ovulate

naturally from both ovaries in a single cycle (that's how naturally

occuring non-identical twins are conceived) - though less common without

fertility drugs.

If you don't have a complete vaginal septum, you have no control over

which uterus might carry the pregnancy if you conceive naturally, since

semen will enter both uteri. I don't think you can really know the

capability of a uterus to carry a pregnancy to term until it's been tested

by a pregnancy that goes into the second trimester. It's a heartbreaking

process, but I don't see how a doc could be sure in advance that a uterus

couldn't carry a pregnancy to term or something close to term.

> I don't assume that

> I have a problem getting pregnant. My DH and I started trying last

> Nov/Dec. and got pg in March (m/c), waited 3 months like my gyn asked and

> then tried in late June/early July and got pregnant, (#2 m/c).

It's terrible about the miscarriages, but your fertility sounds just great.

I think the fertility in the general population in any single cycle is

about 16% - most couples take a while to get pregnant, but most(80-90%)

will be pregnant within a year. Based on your history, it looks like your

odds of getting pregnant again quickly are way better than average.

> Were your m/c consecutive?

No, I miscarried with my first and third pregnancies - both at around 8

weeks gestation. It feels really terrible at the time, and definitely made

me more distanced about subsequent early pregnancy (conciously trying to

remind myself to think 'I'm pregnant' rather than 'I'm having a baby' until

I'd got to 13 wks or so). However, miscarriage is such a common problem and

I didn't necessarily put it down to the UD. More stats, I'm afraid: about

20% of all confirmed pregnancies end in miscarriage, and some docs estimate

that the figure would go up to 30-40% of all conceptions, if the v. early

miscarriages in undetected pregnancies were included. Obviously, there can

be some specific reasons for recurrent early miscarriage, some to do with

having an MA (issues with implantation and blood supply to the placenta etc

- but this is more a problem for women with SU, I think) or for another

reason (genetic, immunological) - but if (God forbid) you were to have a

third consecutive miscarriage, you might be better off getting your doc to

investigate the causes of the m/c rather than trying to boost your

fertility.

As for the other hazards of pregnancy with UD? Well, there's probably not a

great deal you can do to prevent preterm labour if it's destined to happen

to you - though if you have a proven incompetent cervix cerlage may make a

difference. More important is making sure that the best interventions are

available if it does happen - drugs to promote lung maturity before birth,

the very best NICU care etc.. BUT - and this is important - the causes of

late miscarriage/preterm labour and birth are completely different from the

causes of early miscarriage. The fact that you've had early miscarriages

doesn't indicate any greater risk of late miscarriage or preterm labout.

With UD you have a higher chance of having a breech baby, and these days

that almost certainly means a c-section. But otherwise, you can have a

normal labour and birth.

Good luck with trying to conceive, and don't forget to have fun trying.

Judith

ps. Just scrolled down and looked at your earlier post again - why endo

biopsy? I know that some MAs (those caused by DES) have higher incidence of

cancers, but is this really necessary in your case? What are the biopsies

for? And you should try to confirm 100% that you are UD - I don't think a

pelvic exam, plus ultrasound is sufficient - gold standard would be

lap/hyst so they can see the shape inside and outside of the uterus/uteri.

It's a day surgery usually under general - though I guess it could be done

with regional anaesthesia, a bit painful afterwards (you'll feel like

you've been pumped full of air) but done with tiny fibre optics, so no real

invasive surgery.

Share bookmarks: http://groups.yahoo.com/group/MullerianAnomalies/links/

Share files:

http://groups.yahoo.com/group/MullerianAnomalies/files/

The Congenital Uterine Anomalies Home Page:

http://www.wegrokit.com/uterineanomalies/

es/

The Congenital Uterine Anomalies Home Page:

http://www.wegrokit.com/uterineanomalies/

[Guest guest]

Hi Brandee

during my workup following my 2 M/C I had a endo biopsy. I was told it was to

double check if I had a a virus that can cause women to M/C ( I didn't wright

down what virus but know its treated with antibiotics). It is also checked with

a vag or cervical swab. she also said that the biopsy when done around day 23 of

my cycle confirmed if I ovulated. Mine was done in office and was uncomforable

when she was taking the sample 2 in my case bc the first wasn't large enough.

They found from this and bloodwork that I don't ovulate every month, and didn't

have the virus. I started my first cycle of clomid this month.

Someone was mentioning about the risk of twins with clomid and I was worried

about this. I was told by an RE (that I know, not my dr) that the chances of

twins is only 7% and if you don't release any eggs I wont get P G at all. That

is the that helped me decide to take the clomid.

thke care

Leah

resected 03/05

m/c 04/04 11 wks

m/c 09/04 17 wks

ttc round#1 clomid50 mg

__________________________________________________

[Guest guest]

Hi Brandee

during my workup following my 2 M/C I had a endo biopsy. I was told it was to

double check if I had a a virus that can cause women to M/C ( I didn't wright

down what virus but know its treated with antibiotics). It is also checked with

a vag or cervical swab. she also said that the biopsy when done around day 23 of

my cycle confirmed if I ovulated. Mine was done in office and was uncomforable

when she was taking the sample 2 in my case bc the first wasn't large enough.

They found from this and bloodwork that I don't ovulate every month, and didn't

have the virus. I started my first cycle of clomid this month.

Someone was mentioning about the risk of twins with clomid and I was worried

about this. I was told by an RE (that I know, not my dr) that the chances of

twins is only 7% and if you don't release any eggs I wont get P G at all. That

is the that helped me decide to take the clomid.

thke care

Leah

resected 03/05

m/c 04/04 11 wks

m/c 09/04 17 wks

ttc round#1 clomid50 mg

__________________________________________________

[Guest guest]

Hi Brandee

during my workup following my 2 M/C I had a endo biopsy. I was told it was to

double check if I had a a virus that can cause women to M/C ( I didn't wright

down what virus but know its treated with antibiotics). It is also checked with

a vag or cervical swab. she also said that the biopsy when done around day 23 of

my cycle confirmed if I ovulated. Mine was done in office and was uncomforable

when she was taking the sample 2 in my case bc the first wasn't large enough.

They found from this and bloodwork that I don't ovulate every month, and didn't

have the virus. I started my first cycle of clomid this month.

Someone was mentioning about the risk of twins with clomid and I was worried

about this. I was told by an RE (that I know, not my dr) that the chances of

twins is only 7% and if you don't release any eggs I wont get P G at all. That

is the that helped me decide to take the clomid.

thke care

Leah

resected 03/05

m/c 04/04 11 wks

m/c 09/04 17 wks

ttc round#1 clomid50 mg

__________________________________________________