Uterine Abnormalities (septums, bicornuate, etc)

Discussion in 'Overcoming Infertility' started by MyrtleWarbler, Jul 4, 2008.

  1. MyrtleWarbler

    MyrtleWarbler Super Moderator Staff Member

    I figured I'd start a little topic to talk about the particular fertility issue that has affected me. It's fairly common, though doesn't seem to be as common as endo, pcos, mfi, and some of the other lovely issues we get to deal with! Of course, many of you have heard my stories, but I figured I'd track it here for the reference of possible new members and anyone who discovers they have the same problem.

    When I had my sonohystogram, they discovered two abnormal structures in my uterus.

    One is an adhesion, which is scar tissue. It stretched like a diaganol line across my uterus and kept it from "opening" fully with the saline. To have just one adhesion (all they see, for now) could be random, and probably isn't too uncommon. Usually adhesions are the result of infections or D&C procedures. I've had neither (unless an infection went undetected??). Severe adhesions can prevent proper menstrual bleeding, and that condition is called Asherman's Syndrome. I don't believe I have that. Just the one stupid adhesion, we hope. DH described it like pinching chewing gum and then stretching your fingers open, lol!

    The other thing they found was a septum. Fascinating, really. Did you know that when you are forming in your mom's uterus, you start out with two tubes called Mullerian Ducts (hey, everyone should discover something and get it named for them!). They develop into the fallopian tubes, and come together, and fuse to form the uterus. If that fusion process in incomplete, you can have some kind of "Mullerian Anomoly." These include bicornuate uterus (one uterus with two distinct cavities), didelphys uterus (two seperate uterii, each connected to a fallopian tube), suptate uterus (uterus with a "wall" of some length dividing the uterus), etc. Pretty crazy stuff, click here for more info if you want.

    So, it's official, I'm an Anomoly. But, I think we all already knew that about me, lol! I have a septum in my uterus. It is not the full length of my uterus, but not "insignificant" either. At one point the ultrasound showed two dark areas (openings) with a white area between them (the septum)... Like looking up a nose, lol! We won't know the exact extent of either of these things until I have surgery.

    The thing about these anomolies (both the adhesion and the septum) is that they don't necessarily prevent getting pregnant (though they certainly don't help), and some women even carry full term with no problems. My HSG was clear and I bleed fine, so they don't have me fully blocked. But they are notorious for causing miscarriage and pre-term labor, because the uterus just isn't shaped right or flexible enough to accomodate the baby as it grows. Many women aren't diagnosed until they have these unfortunate losses. So, I guess I'm lucky they found it now.

    I will have a Hysteroscopy to cut the septum and adhesion. Makeover and Remodel my Uterus! While I'm knocked out, they will also do the ever-popular Laparoscopy, to look for Endometriosis. Just in case. Something like Endo would be more likely to cause no-BFP than just the uterine issues, but I'm glad to be getting those things fixed!

    So there you have it. All this time I was happy I ovulated regularly and considered myself lucky for that. My hormonal systems check out fine. Who knew my uterus had structural issues!? Until my surgery, it has been condemmed, closed to occupancy by putting me on the pill. I'll keep this thread posted!

  2. Tempting Toffee

    Tempting Toffee Active Member

    Re: Uterine Abnormalities (septums, adhesions, etc)

    Do you want to go on the pill?

    I'm glad you know now, and can get it sorted :)

  3. MyrtleWarbler

    MyrtleWarbler Super Moderator Staff Member

    Re: Uterine Abnormalities (septums, adhesions, etc)

    No, obviously I don't want to be on the pill!! I had to go on the pill in preparation for my surgery, so they would have "control" over my cycle. Sometimes they can just time the surgery with your natural cycle, but the clinic only does this surgery on Thursdays so this was the easiest. Certainly is ironic for me to be back on the pill, but I do what I gotta do.

  4. MyrtleWarbler

    MyrtleWarbler Super Moderator Staff Member

    Re: Uterine Abnormalities (septums, adhesions, etc)

    bump... (And, I still want to add my hyst/lap photos... I will, I swear!)

  5. Rachellia

    Rachellia New Member

    Re: Uterine Abnormalities (septums, adhesions, etc)

    I've never been pregnant, but after 2 failed IUD insertions and some interesting findings, I've started to wonder if I may have a septum defect.

    For the second time in 4 months, I went in to get my Paragard IUD inserted. The first time, it stopped 1 cm. shy of where my uterine fundus appeared to be on the ultrasound. Thinking it was a fluke, the doctor removed it and rescheduled me for another insertion. Much to her alarm, the IUD lodged in the exact same place.

    She was baffled, and said she'd never seen that happen. She also said it was odd that on ultrasound my uterus measured 7.1 cm, but with the sounding device I was just 6 cm. She went over the ultrasound looking for growths/blockages/a uterine tilt, but found nothing. And I distinctly recall her saying to the PA, "It's as though the IUD is hitting something..."

    In an IUD forum, I posted this conundrum and everyone seemed to think it was odd save for one woman who noted the exact same thing happened to her and that an MRI found she had a partial septum.

    I'm going in for a second opinion tomorrow, and I'm nervous. Not only do I want a normal uterus so that the IUD can fit, but I also don't enjoy the prospect of multiple miscarriages if and when I decide to have children.

    My question to you is, have you ever experienced a difference in the depth to which you appeared from the side on ultrasound, but measured differently with a sounding device? I wonder if this is something that would be common if one has a septum.

  6. MyrtleWarbler

    MyrtleWarbler Super Moderator Staff Member

    Re: Uterine Abnormalities (septums, adhesions, etc)

    Rachellia, I don't have any experience at all with IUDs, but your theory does make some sense. Except, I didn't think IUDs went in far enough to hit a septum?? Anyway, when they did the ultrasounds, was it just a regular ultrasound, looking at a "deflated" uterus? (It would have appeared long and narrow, like two thick white bands with a narrower black band between) Or, did they "inflate" the uterus with saline solution for a proper look? A partial septum, especially one just about a centimeter or two, may NOT show up on a normal ultrasound at all! My septum was 2 cm, and my regular baseline ultrasound was normal. Only my SHG (saline-filled ultrasound) revealed it. It may be that you need a different kind of test! I don't know what kind of doctor you are seeing for a second opinion, but learn what you can in advance about uterine (aka "mullerian") anomoly diagnosis. It's not always simple.

    A small septum is very easy to repair, and fertilty following repair is no longer impacted by the septum. In fact, lots of women with small partial septums have no trouble at all with their pregnancies. But, it is definitely worth having fixed if you discover you do have one.

  7. MyrtleWarbler

    MyrtleWarbler Super Moderator Staff Member

    Re: Uterine Abnormalities (septums, adhesions, etc)

    Oh, and I did add a link to view my hysteroscopy photos, in the Laparoscopy Experiences thread! ... If you want to see how a septum would appear "from the inside" [​IMG]

  8. *mel*

    *mel* Super Moderator Staff Member

    Re: Uterine Abnormalities (septums, adhesions, etc)

    I don't know if this is classed as a uterine abnormality or not, but when I had my lap they discovered that the reason my left tube was blocked is because it never developed properly, not only that but it seems the left side of my uterus didn't either. Has anyone ever heard of this? I looked on google and can't seem to find anything but don't know if there is a medical term for it? I am sure I will find out more details when I go for my next appointment but I did ask if this would cause problems in pregnancy and he said it shouldn't but he did say it means my uterus is smaller than it should be? I would just like to prepare myself with more info if possible, don't want any nasty shocks when the time comes!

  9. MyrtleWarbler

    MyrtleWarbler Super Moderator Staff Member

    Re: Uterine Abnormalities (septums, adhesions, etc)

    Mel... It sounds to me like what you have is, in fact, a kind of Mullerian Anomoly. It's OK, all the cool kids have one. (JUST KIDDING!). It sounds like it's not exactly a unicornuate uterus, but sort of tending in that direction... underdeveloped half, but not completely missing. From my initial post... Click here for more info...

    If you search google using the terms mullerian, unicornuate, underdeveloped, rudimentary tube, etc, you might find more info about your situation. I think yours is not nearly as severe as a true unicornuate uterus, not even close, but that it was probably the same kind of developmental failure that caused half of your parts to not develop fully. That link I posted is a great place for info, but I just looked and didn't see much about your specific kind of "sorta" situation. Maybe some new search terms will help you find something? Good luck!!

  10. *mel*

    *mel* Super Moderator Staff Member

    Re: Uterine Abnormalities (septums, adhesions, etc)

    Well it's official, I do indeed have a unicornuate uterus. Seems it's very rare, trust me to be an oddball!

  11. Seerah

    Seerah Member

    Re: Uterine Abnormalities (septums, adhesions, etc)

    Hey Ladies,

    Just starting up this thread because it turns out I have an arcuate uterus; basically a small dent at the top of my uterus like a loosely drawn heart!

    I'm just wondering if any other women out there have an arcuate uterus and if they had any corrective surgeries (hysteroscopy)?

    Thing is, my RE said that the small dent shouldn't really be a cause for concern, then he kind of changed his mind as like, well we should go in there and take care of it. ?!?

    In one way I don't want to have to go through even such a minor out-patient type of surgery, but then again, if they go in not only can they fix that but I'm hoping they'll check around because I seem to have an issue with the right side of my uterus. When they did a water sonogram nothing was seen going into the tube on the right side (either blocked or not there!) and they've had problems locating my right ovary!

    Good thing is, my left side seems just fine! The left ovary is pretty active and there is no blockage in the tube! It only takes one, right?

    Well, if anyone has any info, please let share! Thanks!

  12. *mel*

    *mel* Super Moderator Staff Member

    Re: Uterine Abnormalities (septums, adhesions, etc)

    I'm not sure if you checked out the link Seerah that MW posted in the first post but I just had a look and it said this about your condition.

    Arcuate uterus (AU): The fundus of the uterus may be indented slightly both inside and outside. This shape has been variously defined as slightly bicornuate and slightly septate (and may be either one), and is so slight that it is considered a variation of normal. However, a few studies suggest that increased incidence of adverse pregnancy outcomes are associated with an arcuate uterus.

    I know it was a while ago you posted so maybe you made a decision on having surgery or not? Have you had a lap? Here in the UK it's standard after suspecting a blocked tube to have a lap to try to find the reason for the blockage. In my case it was a good job they did, I had endo too even though I had no symptoms! I was about to move onto IUI which they pretty much told me would definately not have worked with the endo still there! They could never find my left ovary, turns out it's in an odd place due to my unicornuate uterus but in IVF it actually worked far better than my right one and produced nearly double the amount of eggs!


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