Hysteroscopy #2: Arcuate Uterus

Arcuate uterus: that’s the latest term the docs are flinging around these days. Yeah, I know, the title to this post sounds like a sequel to a bad movie. But if all-things-uterus-related are your thang, then, please, read on:


 

Yesterday, after having had something like 4 periods in 5 weeks, Dr. C determined that I’d finally had a “second” period and did my second hysteroscopy. I felt very fortunate that my h/s was scheduled on a day that Dr. C was the surgical clinic doctor and he’d be doing my procedure: there’s just something about having your own RE that makes it so much more comfortable. Well, as comfortable as someone lacing a camera through your cervix and taking an extended video tour of your uterus can be.

The h/s showed that I had no fibroids, polyps, or fetal tissue left in there, so we checked all that good stuff off the list. But then Dr. C was all like, “Hmm, it looks like you have an arcuate uterus. It’s not too bad, but it’s definitely arcuate. See?” He showed me something on the screen that looked (to me) like just a watery blur, explained the condition to me in best-and-worse case scenarios, then wrote it down on a piece of paper. “I know you. You’ll be Googling this the minute you’re out of here. So here’s how to spell it.” Ahh, my doc and I: he knows me so well.

After a bicornuate uterus was ruled out the other month, I’d thought little more of the matter than just my having a weirdly-shaped uterus. But apparently there’s several different medical conditions in which a uterus can be jacked up, and now they’re trying this one on for size.

I, of course, Googled as predicted. I’ll save you the dry, unintelligible, medical definition: here’s an easier explanation that I found online:

A small “dent” in the top of an otherwise normally shaped uterus distinguishes this condition. The Mullerian ducts have fused but have not reabsorbed completely. The problem does not seem to have much effect on normal pregnancy so seldom requires treatment.

arcuate uterine-abnormality

From what I’ve found, an arcuate uterus can be a cause of very little concern:

“…the arcuate uterus probably does not have an impact on reproduction and obstetrical outcomes.”

“… a minor malformation with a benign clinical behavior…”

“According to these results, there is no evidence to support that the arcuate uterus has a different effect on the reproductive outcome in comparison to the subseptate uterus, neither before nor after surgical correction of the anomaly.”

On the other hand, arcuate uterus can have an effect both on fertility and the ability to carry a child to full term. Specifically, it’s suspected of contributing to second trimester miscarriages. Some websites say arcuate uterus is common, others say it only shows up in 3 – 4% of patients scanned.

Fun stuff.

The Plan: So every Monday Dr. C sits down with the other REs in the practice to review cases from the past week that they want to get the others’ opinions on. They’ll make some popcorn, sit back, and engross themselves in re-watching the video taken during my h/s.

Then they’ll tell him what they think I should do. Then he’ll tell me what he thinks I should do.

What Dr. C thinks: For now, wait. If his colleagues suggest that I have my uterus “corrected” then I can have a procedure done to fix it. Will not fixing it affect our upcoming transfer this spring? Maybe. Buuuuuut… maybe not. Dr. C thinks I’ll be okay…. buuuuut he doesn’t want to take a risk of messing up my future chances.

Bottom line: He doesn’t know yet. Therefore, I don’t know yet. The clinic will call me next week with an idea of what to do going forward.

Update to follow.

 

Author: Marixsa

Resolving infertility as childless-not-by-choice and encouraging fellow endo warriors along the way.

19 thoughts on “Hysteroscopy #2: Arcuate Uterus”

  1. They tried to tell me that after my second hysteroscopy as well. I think it was actually Dr. C that did the procedure, too. Dr. G. reviewed everything and determined that it was so slight that it did not matter. My completely non-medical opinion is that if they did not catch it the first time around, it’s not a big deal. Also, another unsolicited, non-medical opinion: I don’t think this contributed to your miscarriage. I think blighted ovums are usually attributed to something being genetically wrong with the embryo and not something structurally wrong with you. If that’s the case, I think it’s “good” news. If something was genetically abnormal with the embryo (pretty common), then you have a completely fresh start with your frozen guy! Dr. G assured me that one embryo being abnormal did not mean future embryos would be. I’m glad Dr. C is investigating everything, but I think you’ll be fine! Did Dr. C run the recurrent miscarriage panel of tests on you? If not, maybe ask him to do that? This is your second loss, right? The tests is just some bloodwork, no biggie. I think it could be a good idea to rule out any clotting factors. This panel of tests is where I found out about the antiphospholipid antibody business. Apparently, blood clotting stuff is commonly in endo patients, according to Dr. Braverman anyway.

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    1. This isn’t the first time Dr. C’s told me something that another doctor later dismissed. He can be overly cautious, and sometimes that can make me a little ‘meh’ toward him.

      As for the recurrent m/c panel, no one ever mentioned it to me; guess I’ll mention it to *them* though…. Sometimes I wonder if I just kinda slip through the cracks in patient care. Good call.

      Like

    1. Thanks! Here’s hoping I don’t have to do ANYthing. I really don’t want anyone messing around in there too much. I have a feeling this might just be overkill and to leave well enough alone.

      Liked by 1 person

  2. Interesting! Hopefully they feel as though it’s not of enough concern to fix. I agree with the above suggestion of asking for the recurrent miscarriage panel. I have a good friend who had it done last year after her second loss and they found out she has a blood clotting disorder!

    Liked by 2 people

    1. I’m def going to demand a panel. I think they’ll say that the blighted ovum wasn’t a problem with me but with the embryo, but for the sake of a blood test it’s worth looking into.

      Liked by 1 person

  3. the joys of dr google – on one hand, everything is fine and most people have it, on the other…. it’s more rare and can cause X and Y… how is anyone meant to feel confident about anything?!
    Sounds positive that they found no fibroids and/or polyps… and I really hope that whatever the drs conclude will help you for your next transfer xx

    Liked by 1 person

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