Mar 25, 2012

what next?

First, thank you for all the love & support. I know I have been totally flaky about responding to comments, but know that I read and re-read your comments and they help me through the day.

Today we went back to the RE for a 2 week follow-up appointment. The big decision we need to make over the next week is whether we want to do a myomectomy to remove my jerk fibroids or not. I was a bit shocked - when we asked how soon I might start a fresh IVF cycle if we do not do the surgery, Dr. T. said we could start right after Passover. (Passover begins April 6.) We will actually be away for most of the month of April, so we wouldn't be able to start until the last week of April, but that is still much sooner than I was anticipating.

On Thursday I will have another diagnostic hysteroscopy to get a better handle on the current fibroid situation. There definitely seems to be a consensus that one of my fibroids likely played some role (how much of a role is very debatable) in my problems with Aminadav's sac and placenta. While all of my fibroids grew with the pregnancy, none of them are objectively huge.

The two bad guys are the ones that bulge into the uterus. If we elect to remove them, they will need to be removed from the inside of the uterus. The problem when operating inside of the uterus of course is the potential to create scar tissue, adhesions, and other various types of damage which could cover more surface area than the original fibroids themselves.

Dr. T seems to think that I just had exceptionally bad luck with where Aminadav implanted in relation to one of the two problem fibroids and that it's better not to mess with my uterus any more then strictly necessary, though the doctors during my hospitalization seemed to be more in favor of getting the fibroids out before we attempt another pregnancy. We'll see what the surgeon says on Thursday and then we'll have to make some sort of decision.

I am unsure of what I want to do re: the fibroids and also quite unsure of on what type of time scale I want to pursue IVF moving forward, but before really delving into that I think we need to reach some sort of consensus on the surgery. Any folks out there that have done a myomectomy via surgical hysteroscopy or considered doing it? Any wisdom or thoughts?


  1. I didn't have fibroids to remove, but I did have hardened left-over placenta that needed to be removed via hysteroscopy. My RE is firm on the idea of creating an ideal environment for a potential embryo. I did the surgery and they placed a balloon catheter into my uterus to prevent scar tissue. It was left in for a week before coming out. I then did a SHG a couple of months later to confirm that the surgery was successful and there was no scar tissue. All was clear.
    That was my experience and it was less of a choice for me as the mass was taking up too much space in my uterus.
    If you aren't too opposed to waiting a little longer to try IVF, maybe clearing out the womb would be a good thing.
    I wish you luck on your decision and hope you get to move forward this spring.

    1. So this is actually exactly where we are right now - despite having already had a d&c, the hysteroscopy showed retained placenta and there was too much placenta to even see the fibroids. So now the plan is to do an operative hysteroscopy in a few weeks to remove the retained placenta and then the fibroid surgery would have to be a separate procedure. I am so sorry this happened to you, too, Alissa with the retained placenta. It is is really frustrating and sucky at a time when i just want to move forward with healing.

  2. It's good to hear from you, I hope that you are doing okay. I have been thinking of you.

    I had a robotic myomectomy after a unsuccessful hysteroscopy, when the surgeon went in the first time the fibroid was larger than what they originally thought based on the diagnostic tests. He didn't want to attempt to remove the fibroid the first time and scheduled a 2nd surgery, i was really frustrated! He wouldn't allow us to
    move forward with ivf until the fibroids were gone. Turns out the fibroid was taking up a fair amount of real estate in the cavity. I feared scarring and damage to my ute but it turned out fine.
    A year and a half later I am close to the end of my pg. I have some new fibroids and have been told that some women are prone to get them, great.
    It is a difficult personal decision to make, there are many of us who have had myomtectomies with excellent results. If you want to talk more I can be reached at chunkbee at yahoo dot com. I can also point you in the directions of some other blogs too.
    Much love to you!

    1. Good to hear you had a lot of success with the procedure! It does seem that those of us who are prone to them seem to get new friends popping up, unfortunately, regardless of what has become of the original one(s).

  3. I don't have any advice about the fibroids, I'm a little surprised that Dr. T wasn't more forceful about whether to get them out. It could have just been bad luck with Aminadav, but what are the chances that bad luck like that could strike again. I'm impressed at how brave you are to start cycling again. It's not easy. Lots of love and support with your decisions.

  4. Alissa, I have a very good friend who has had a myomectomy. I am happy to send you her email if you'd like to talk to her.

    Continually thinking of you.

  5. It is an incredibly difficult decision to make when there isn't a "definite" answer on either side.

    Wishing you strength and peace as you make these decisions.

  6. Wow, they allow you to start IVF very soon...that is good for healing and for distraction, I wish they had allowed me that, but they made me wait a full three cycles, which took about four to five months. I was so bored and impatient I could have died.

    As for the myomectomy, you need to make a decision knowing that no matter what decision you make there are potential negatives. so you will not have all the data needed and the decision will leave you wondering. In this case, just go with your gut feeling after you hear all of the informed opinions out there, and then don't regret whatever you decided. Just assume it was the best decision. which of course it will be, otherwise you would not have made it.
    BTW, are there any studies out there about pregnancy rates after myomectomy? just google infertility after myomectomy, or fertility rates before and after myomectomy, something like that.

    1. MrsH - You are absolutely right that I need to further research fertility outcomes following myomectomy of intramural and submucosal fibroids for myself. As you will see from my current post, it would seem that my body is sending strong signals that my next ivf won't be for quite some time :(

  7. Sending you strength and peace as you make some difficult decisions.