Ashermans-Dr. Jane
RICHMONDTB - Jan 22nd, 2007 6:04 PM
[ Original Post ]

Hi Dr. Smith and Dr. Jane
I just found your website today and glad I found it, you guys do an great job for us, and we do appreciate it
My story is somewhat not a good one, and I hope that I can get some hope

I have been through the mills with our treatment, we have recently been diagnosed with Ashermans syndrome. Unfortunately, about 7 years ago, when we started on our fertility treatment, the first stop was a myomectomy. Unfortunately an infection sat in during the recovery, and scar tissue formed. I had an abnormal HSG, after that surgery.
Two more uterine surgeries were performed, followed by a D&C, which caused more scarring. The last of those two surgeries, was a hysteroscopic rectoscope.

Recently to repair or remove the scar tissue,
I have had a hysteroscopy where the cavavity of the uterus was cored out with microscissors, & a repeat hsg shows the rescarring did not go across the uterus, but there may be some still in the endrometrial lining as that area was not entered during the surgery.

To determine if I still have scar tissue in the lining,
I have just finished an mock cycle where I had an endrometrial biopsy at the end to determine if the scar tissue was pushed out of the lining. My ultrasound should a lining of 7.8, and estradoil around 92

I do not know the results of the endrometrial biopsy as yet.
If the scar tissue is removed, completely, will there be a chance to carry the pregnancy and also I have adenomyosis and how will that factor into things.

I have been tested recently by a hemtalogist for all the immune issues and came back negative, I am an older patient.
Any insight you can share would be great. WE have 12 donor egg embryos on ice now.
We are sending our file to Dr. Smith to review for the viability of the embryos.
any help would be greatly be appreciated

Brenda

Comment


 

Dr Smith - Jan 23rd, 2007 11:10 AM

I'll look over the embryo records. The uterine questions I will forward to Dr. Jane. Whew! You've been through a lot!


RICHMONDTB - Jan 23rd, 2007 1:58 PM

Hi Dr. Smith
I want to warn you, that you may do some strength training before reviewing my file, to prevent any injury to your arms, it is a big file ;D

We do appreciate this website and your dedication to help couples achieve their dreams of a family.
Thank you for so much for your time and dedicated answers to the many posts through the years. I look forward to talking with you.

Brenda


Dr Jane - Jan 23rd, 2007 2:39 PM

Hello Brenda,
I'm sorry you went through al that you did. It just doesn't seem fair, does it? There are 2 ways to stimulate the endometrium to grow and, if we could try both. If we are satisfied with the response than FET could be done. I'm glad the embryos are frozen - they are safe there until thawed. This means that they stay frozen until an adequate endometrial pattern is obtained. If I were to see you I'd need a copy of the hematologic tests. I'm wondering if all applicable have been done. Whatever has been done - I'm glad they were neg.!! Now: worse case scenario: using a surrogate uterus to carry your embryos. Remember - they are "Safe" while frozen.
Yours,
Dr. Jane


RICHMONDTB - Jan 25th, 2007 1:33 AM

Thank you Dr. Smith and Dr. Jane
Thank you Dr. Jane, for saying you are sorry for what we have been through.
I have sent my file to Dr. Smith, and you will be able to better tell about the events in my past care and I am so looking forward to my consultation with Dr. Smith.


Unfortunately with this mock cycle, I did not get a trilinear pattern. Normally I was developing a 10.8 lining in prior cycles. We have had a leading Ashermans RE review my file and the hysteroscopic rectoscope did remove part of the myometrium, which was not good.
Fortunately the fibroids that were removed were small, but the myometrium was entered and the fibroids were taken from the wall, even though the majority of the fibroids were in the wall :'(

I have not heard on the results of the endrometrial biopsy, and hopefully it will be good news.

You mentioned 2 ways to stimulate the endrometrium
what is the other way?


I have had 3 transfers, and now 2 miscarriages. the first with my own eggs. then with the other donor eggs, and there could of been a sperm chromatin issue with this miscarriage
those embryos were not cultured to day 5 and I am not sure if the culturing the embryos to day 5 could of given insight to the unknown sperm chromatin.
dr. smith?
We as the last option want to use a surrogate bc the quality of the embryos is not known

the last fresh cycle the donor did hyperstimulate and there was an egg issue per the embryologist but the RE denied knowing anything about an egg issue. ::)

thanks again to both of you and I have some glimmer of hope at least getting information.
right now every is just saying our prior care was a disaster.
Brenda

I was pleased to use a good transport company getting the embryos at the current NorthEast facility. So the transporting of the embryos, I think we are fine.


I am so looking forward to Dr. Smith evaluation of our embryos.
Again many thanks for your time and dedication to this website.



RICHMONDTB - Jan 25th, 2007 10:17 AM

Hi Dr. Jane
I can request a copy of my hematotogy reports from the independent hematologist. Per the hemtalogist he said I did not have an immune issues, but I can request thos for you. He said most immune issues impact pregnancy in the 2nd trimester. Is this true?

do you believe in embryo toxicity tests?

When would Ashermans or undetected scar tissue impact pregnancy? or does the amount of scar tissue impact the implanation and or pregnancy

I will request these records and also forward and schedule a phone consult with you as well.

I think I understand what the current clinic is doing, but not sure. I have adenomyosis, and it is my understanding with adenomyosis, the response to the progesterone could be altered n the endrometrial biopsy, and so also by doing this endrometrial biopsy we can see if I am out of phase with the progesterone which could be leading the reason for the miscarriage.

My case is quite complicated.
thanks for you kind reply and I do appreciate your insights.
Brenda


sushpi - Jan 25th, 2007 3:18 PM

I was wondering, too, about the 2 ways to get the endometrium to grow. I've done 2 DE cycles, and 2 mock cycles, and have never gotten triple striped. My protocol is lots of estrogen!