The Busy Beaver

A clever title to add a little humor to what has been one of the worst days of my life. I will make a solid attempt to describe what the doctors have found in understandable terms.

Here's the diagnosis: Unicornuate Uterus with Communicating Horn

Yup, certainly is a mouthful.

The uterus and fallopian tubes form in a developing baby from two separate ducts, which fuse together in the middle to create the uterus. Many things can go wrong during this complex process. When only one of original ducts develops, the result is a unicornuate uterus -- a uterus of half the normal size, with one fallopian tube. However, development of the ovary is determined separately, and usually both ovaries are present in women with this anomaly.

A CT scan of the pelvis (mine is on Thursday) or a transvaginal ultrasound (completed today)may well show that your ovary is in fact present (they are.)

Three separate subtypes of unicornuate anomaly are: a unicornuate uterus with a rudimentary horn that does not contain endometrium; a unicornuate uterus with a rudimentary horn which does contain endometrium but does not communicate with the main uterine cavity; and a unicornuate uterus which has a rudimentary horn which contains endometrium and does communicate with the main uterine cavity (mine is the last one.)

A unicornuate uterus can support a normal pregnancy. About 40% of pregnancies will end in spontaneous abortion, 20% in live births. Unicornuate uterus may go undiagnosed until the patient is evaluated by a hysterosalpingography HSG (Yes, that was where mine was discovered) or is subjected to a surgical procedure. At HSG, the uterine cavity is a "banana" shape, and curved to one side, instead of having a normal triangular shape (Fig.1). Only one tube works properly.

People who have a unicornuate uterus are more likely to have endometriosis (I'm not surprised,) increased chances of miscarriage (not shocking,) and have premature labor. Furthermore, I am only ovulating every other month due to the fact that I have only one fully functioning fallopian tube (due to this condition.)

So, basically my uterus is smaller than a normal one, and is not receiving as much blood flow as a normal uterus. The reason for this is that there is another smaller "uterus" on the lower right side. The smaller uterus is not capable of sustaining pregnancy, and if an egg implants there, it will 100% end in a miscarriage. If an egg implants on the left hand side, it will receive less blood and will only stretch to a certain size. I still have to determine how large of a baby it is capable of carrying. What happens is, say it is only capable of holding a four pound baby, once the baby is four pounds, my uterus will no longer stretch and I will go into labor. So, people with this are placed on bed rest for the majority of their pregnancy.

In addition, due to the way a baby develops while in the uterus, people with this condition are also at a high risk of kidney problems. So, I am also scheduled to have my kidneys examined.

It was an interesting and devastating day. I'm emotionally a mess, and am about to begin rounds of testing that will bring with them even more information to digest. I never saw this one coming. For the past few years, my emotions regarding my infertility have been all over the map from anger and depression to excitement. I've lashed out, felt misunderstood, and just now, I'm learning to reach out. It's difficult though, because what is happening is so intensely personal. How exactly to digest what today brought is still a mystery to me. It's not just me that it affects, but my husband, family, and friends as well.

Tomorrow they are checking my glucose, prolactic, insulin level, TSH, and progesterone. Thursday is my MRI and CT Scan. The first date I could get with the RE (reproductive endocrinologist) is October 10th. This too is even upsetting. First it means that I have to wait patiently for October, (which feels like forever from now), second I will miss my cousin's wedding (whom I love dearly,) and third I will be missing visiting my husband's parents which was slotted for that week. What a mess.

The only positive thing I took from today was that I have a wonderful husband, amazingly supportive parents, and some wonderful friends who have hearts of gold. I love them all.