Asherman’s Syndrome

Another diagnosis to add to my infertility lineup. Premature ovarian failure, diminished ovarian reserve, low AMH, MTHFR C677T/C677T, and Asherman’s syndrome. I am so glad my doc required a meeting yesterday. He explained to us with the visual aid of the internal ultrasound in live time that my entire uterus is collapsed upon itself and stuck tight with scar tissue. Luckily, the cervix is open, so he doesn’t have to create a new one (sounds like fun, right).

He explained that he must stay in the right position during surgery so he can open up my uterus and “create some real estate.” He feels it would be beneficial to grow the endometrium as much as possible because that can provide a guideline for his incisions. I’ll be on estrogen for 21 days followed by prometrium for 5, then surgery, followed by another round of the same meds and a possible second surgery. Surgery will be laparoscopic, through my belly button and another port below my bikini line so he can get a good hold on everything. This also means my belly will be filled with gas to increase the area in sight. Yup, I’m nervous about it. Read more on Asherman’s and treatment here: http://www.ashermans.org/information/stages-of-ashermans/

How did it happen? It often occurs after trauma to the uterus from surgery (such as the two D&C’s I had to remove my placenta after baby J’s delivery). The question mark is why did my placenta stick in the first place? Maybe I am predisposed to scarring and there was nothing that could’ve been done to prevent it. I know the diagnosis could’ve been much worse.

My hubby has been a rock. He has faith that we will get through this. His love makes me stronger.

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None shall pass.

None shall pass.

Today, the trial embryo transfer was a no go. The catheter went only so far and the internal ultrasound revealed some tissue in the way, but everything beyond that looked great! The first time I had the Doppler test to check blood flow, my numbers were over 5 and they wanted them closer to 3. That time, I did get my numbers down close to 3 with acupuncture and diet changes, but this time, my numbers were a little over and a little under 2 – even without acupuncture (though I do miss it)! Woohoo!

Then came the hysteroscopy which we knew was only going so far and, sure enough, we got a great picture of what looked like a shallow belly button (not really a belly button, but that’s what it looked like). Evidently, after my second surgery to remove my placenta 6 weeks after delivery, the two walls of my uterus (just past the cervix) healed together when they should’ve stayed separated. I meet with my doc tomorrow to establish a game plan and set our date for surgery.

Strangely, I’m comforted in knowing there is a diagnosis (Asherman’s syndrome), treatment (surgery), and a confident team of doctors on my side!

What to do…

I’ve been thinking about everything we tried before we finally resorted to IVF. I’ve been thinking about

the pregnancy tests, ovulation tests, fertility monitoring,

the diet changes (no sugar, no dairy, no gluten, no caffeine/coffee/chocolate),

the supplements (DHEA, primrose oil, etc.),

de-stressing (quit a job, stopped exercising, said “no” to more opportunities),

the acupuncture,

meeting with a naturopath,

the Mayan abdominal massage,

the testing, IUIs, hysteroscopies, that painful HSG,

reading, reading, reading, and

the wishing, hoping, and praying.

Now, we are here, on the other side, with a teething toddler and toys everywhere. Is it possible to still be in awe of it all? Am I still in denial that we are actually here? Is it possible we could be so lucky again? Do I go back and try all those things again or do I just ignore the fact that we ever needed treatment? It all feels like a long, long time ago… yet only three years have passed since our miscarriage, two years have passed since our FET.

Tomorrow, I go in for more tests: bloodwork, trial embryo transfer, doppler of blood flow, and another hysteroscopy. I hope all tests will yield positive results and we can move forward in hopes of adding to our family again.