Bionic Mamas

you're not losing a vagina, you're gaining a son

Uterine News And Weird Reports

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You might be a trifle done in, if your foremost thought at the prospect of upcoming surgery is relief at the idea of spending a few hours knocked out.

Returned to the Baby Factory this last week, for another look at my storied uterus. During the last dildo-camming, all appeared normal, but the spotting I’ve been having for up to a week before my period for the past several months made Dr. Baby Factory suspect a polyp, one he might not have been able to see at that point in my cycle, when my lining is pretty plush. Sure enough, at the low-nap of CD 8, there it was, big as life and smack in the middle of everything. Even I could have diagnosed something from that ultrasound, though I might have gone with “spontaneous mini-kidney.”

It’s not huge, as these things go, 7 by 8 millimeters or so. Dr. BF says lots of people get pregnant with polyps. But lots of people have miscarriages with polyps, too, and after watching a youtube video of one getting excised, I think understand why: the sucker didn’t bleed. If there’s one thing I know for sure about uterine tissue, it’s that it ought to be robustly vasculated, embryos not being entirely unlike vampires in their basic desires.

So. Out it comes, via hysteroscopy. That’s hyster- for “uterus” and -scopy for “you’d rather not be awake for this.” Dr. BF only operates on Thursdays, my busiest teaching day this semester. Luckily, he is willing to do this surgery any time I’m not bleeding (some people only do them early in the cycle), which means I ought to just squeak in during spring break, a few days before I expect my period. That gives the ol’ ute April to recover herself for a May FET cycle. Here’s hoping.

If you’ve read, um, anything I’ve ever written here, you know what comes next is the part about how freaked out and anxious I am about all this. And believe me, I’d be telling you aaaalllll about it, except that, well, I’m not. Isn’t that weird? I don’t know who I am anymore, either.

Partly, this is because it will be Dr. BF wielding the scalpel cervix telescope/floodlight/scissors thing. I’ve been peeved at him once or twice (twice) during our time together, but he’s never given me the slightest reason not to trust him. Granted, I am not deaf to flattery, and he did call my ovaries beautiful and remark that he loves my (medically rarer-than-rare) uterus. But it’s more that the initial impression I got when first reading his blog (what? You don’t choose your doctors via blog? Wish Dr. Russian had had one), that here was someone with a careful mind who also really cared about his patients, seems to have been accurate. I was a little surprised, during our Triumphal Return appointment, that he didn’t ask much after the Bean. It occurred to me later, however, that there is something really refreshing about talking to someone who seems mostly interested in me, not just the fruit of my wacky womb.

My mother has a story along these lines, which I’m going to put in here because it is funny and my paragraphing is all to hell anyway. Ahem. Mama went to medical school with a woman who had an identical twin living in the same area. Her twin gave birth, attended by a doctor the med students knew. When she saw him next, the med student thanked him for delivering the baby. He looked blank. Incredulous, she asked, “don’t you ever look at their faces?”

I trust Dr. BF because of the post that led me to him, in which he discussed common mistakes in diagnosing mullerian anomalies, because knowing how to do something wrong is an important part of truly understanding how to do it right. I trust him because I know he cares about his patients, not just because he has been considerate of our feelings (mostly — still holding a grudge over that psych consult), but because his blog was the first (only) place I’ve heard a doctor express disdain for the term “chemical” pregnancy, on the grounds that it diminishes the experience of loss. (That I read this right after Dr. “I’m sure you don’t have a septum even though I’ve never examined you” seemed cozily baffled by my observation that “incompetent cervix” is an obnoxious term makes the memory stand out.) And I trust him because I watched his video of a hysteroscopic resection of a uterine septum, which I heartily recommend if that kind of thing doesn’t squick you out.

I admit that I am pretty sad that this means no travel during break. I had visions of a jaunt up to friends in Boston or down to Starr Hill, but Sugar can’t travel the first weekend, and even though I know recovery from this sort of thing is supposed to be no big deal, the thought of counting on feeling up to schlepping somewhere the following day with a toddler in tow makes me queasy. It’s just, I’m lonely. I hadn’t counted on how isolating this “having a toddler means someone is always sick” business would be, and lately, someone is always sick. (And holy smokes, this latest one is a doozy. It’s taken a week to write this, and it hasn’t been a fun week.) I miss seeing friends, you know, in the ol’ Real World. Guess I should have thought of that before I went and got myself knocked up. Meanwhile, I don’t know what I’d do without y’all, I really don’t.

Speaking of, did you know you’d almost gotten me to not care about the specter of those PIO shots? Only almost, but almost is a big deal in this context. You are a pretty amazing bunch. Drinks, all around.

Which brings me to the appointment’s good news. I admit it, after the PIO surprise, I played the field, support-wise. I will always love y’all best, you know that. But I also asked about it on a forum, and one of the women there asked why I wasn’t doing a “natural”* FET. Was there any reason to believe my previous difficulties were related to my hormone levels?

*someday you will get my rant on how much I hate that word. It’s long.

Well, now that you mention it, no, there isn’t. We’ll never know for sure, but I favor Dr. BF’s hunch that I wasn’t getting pregnant via IUI because of structural issues: the endometriomas were preventing eggs from leaving my ovaries, various adhesions were keeping the Fallopian tubes from picking them up, scarring in the tubes was generally fouling things up, or some combination. Given how very many eggs I made on a moderate FSH dose (32), how much those eggs seemed to like the sperm in question (24 fertilized), and how happily the resulting embryos grew (12 frozen, one currently staring in adoration at the engines of Sodor), these explanations seem quite plausible.

Indeed, I had always imagined we would do an unmedicated FET, but when that’s not what Dr. BF described at our recent consult, I just assumed there was some reason. Insert the usual business of not wanting to look foolish by asking. Yes, it’s a great defense mechanism, why?

Emboldened by my forum friend, this time I did ask Dr. BF what he thought…and it turns out he thinks it’s fine! He might still want me to do some progesterone supplementation, but the good old coochie bullets are fine for that. I asked him about odds, expecting they would be lower than in a medicated cycle, but he said that assuming they don’t miss my ovulation (which would mean game over that cycle — this is why they don’t do many cycles this way), he thinks the odds are about the same.

I feel great about this idea, and not only because it limits the ass-stabbery to one trigger shot. I feel excited at the idea of giving my body a chance to just do its thing — at least, as much as such a thing is possible after embryologists have entered the picture. It makes me a bit warm and fuzzy, it turns out, to imagine trusting my body.

I know. I don’t know who I am anymore, either.

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12 thoughts on “Uterine News And Weird Reports

  1. Wow, so much to comment on (and here I am typing with one hand on an iPhone!) I’m excited for your upcoming cycle, it sounds like things are lining up for a great FET (yay to fewer PIO shots, especially!)

  2. Wow- that is amazing that you can avoid the PIO shots. One trigger is seriously no biggie at all. Good for you for being proactive and speaking up!

    Your doctor sounds amazing.

    Good luck with the surgery. I had a laparoscopy done in early 2009 to excise suspected (proved) endo. I gave a conference paper the next day (within the same city). Definitely don’t recommend that one, so I suspect not travelling is wise, although I have no idea how your upcoming surgery would compare in terms of time spent/pain meds offered, etc.

    I really get you on the sick and the lonely. I am struggling a lot with it right now. We just seem to spread germs between us, so as soon as we all get healthy another round starts. I also hate my dissertation at the moment, and it is the first day of spring and yet still snowing and well below zero, so that is not helping matters. But I also really miss my friends.
    T.

    • Whoa. Sugar had a lap that included a hysteroscopic polyp removal and some digging at endometriomas on her ovaries (plus surveying of endo in general, but no other removal), and she was out of commission — as in, house-bound — for more like two weeks. We went to a (local) wedding a few days post surgery, which turned out to be pushing it. I am seriously impressed that you managed a talk.

      The friend-missing is severe and depressing. I even have some local friends with kids, but it’s no good if we just trade around being unable to do anything because of various dread diseases. Ugh.

  3. Yeah, that’s a fibroid for ya. I had one overtake an ovary, which led to the eventual “Steviction,” and the emm-effer was the size of a baseball but BLOODLESS on the outside. It’s better to get them when they’re still little enough to be JUST fibrous and not starting to vascularize. So glad you have a doctor you trust, although it sucks about Spring Break.

  4. I’m definitely with you on the frustration with terms like “chemical pregnancy” and “natural” cycle. My mom (who had my brother at 29 weeks gestation more than 30 years ago) is a normally mild-mannered woman who has been known to go on at great length about how pissed off she gets by the term “incompetent cervix.”
    I love the story about your mom and her co-worker, and just had a similar experience. In January, Roo and I spent more than an hour in a (pants on) appointment with our practice’s Physician Assistant discussing the possibility of doing IVF. We changed plans to trying with me, and I ended up having the same PA for my HSG in February and said PA acted as if we’d never met before. Then she did my IUI this week and, after a brief moment of difficulty locating my cervix said, “that’s right, I remember doing your HSG. Your cervix tilts to the left.” So she had no memory of my face, but my cervix she remembered clearly.
    Sorry you have to spend part of your spring break having a hsysteroscopy. Maybe you can do fun touristy things in NYC or take a quick trip before that Thursday? But yay for your FET plans!

  5. I had a hysteroscopy for a polyp before beginning cycling. Yeah, it was a great nap. Love I was grateful for the pain meds immediately after, I was fine the next day. Just a little sore. I did take an extra day off work, but I really didn’t need it. On the other hand, with your unique ute, it may be harder. Hope not.

    Please write that rant on “natural.” I’m with you on that. Nothing unnatural about our ART babies!

    As for the FET, since I was travelling for my transfer, completely unmedicated was too unpredictable. First (failed) FET was with Lupron. Awful! Second (successful!!) FET was with lots of estrace (oral) for suppression and to build up my lining. That was SOOOOO much easier.

    Warm weather is almost (PLEASE!) upon us. Playdate somewhere in between us? Have you taken Bean to the Bryant Park Carousel? Much more low key that CP, and they have a lovely children’s reading area next to it. We can sit and chat while the kids play with books. WIN! 🙂

  6. FUCKS YEAH NO ASS STABBERY! That is wonderful news! The hysteroscopy is super NOT good news, but I’m really glad it’s not both. And I love the idea of a vaguely… “naturalistic” pregnancy, or one with greater “ecological validity”, shall we say. Snort. I’m so sorry that your remaining getting drunk and hanging out time is being interfered with by work and sickness. It’s hard. The endless dregs of winter is hard, too. ENOUGH. SUMMER NOW. I hope you can find some kind of spring break treat. I decided to take a fucking day OFF after being pretty much on the go since January (you know, for very luxurious values of “on the go”) and it seems like you’ve been working absurdly hard with your many inconvenient jobs.

  7. Wait, what is a natural FET? I figured that meant that you did the FET at the time of your natural ovulation, but then you mentioned a trigger shot. I am confused. Someone should come up with better terms for this stuff.

    Also, please, please do post your rant about the word natural! I think I remember reading a mini-rant here about “natural” childbirth but it might have been somewhere else.

    I am sorry you’ll have to waste your precious spring break days having surgery. I hope it goes smoothly and is not too painful. Excited for your May FET!

  8. Ah, I come from a nation so backwards the majority of cycles are “natural”. 🙂

    Was a right pain in the butt, PIO excepted because we don’t do that either, for me since I have no ‘natural’ cycle and the HRT version led to intractable bleeding leaving me with nail biters of homeopathic dose FSH attempts wondering if five eggs would get me cancelled (answer, no, after much weeping and pleading, but I didn’t get pregnant, either)

    g

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