My uterus rides the little yellow school bus...

So I thought since everyone is not as well versed as I am in the matters of the reproductively challenged, I should give a few explanations so that you know what the heck I'm talking about when I mention some medical term, in a blase fashion, as if I were saying "white toast"...

After 2 miscarriages, 1 in 3/05, and then a m/c of twins in 5/05. I was referred to an RE(reproductive endocrinologist). Upon a regular transvaginal ultrasound (yes it IS as lovely an experience as you would imagine...) my RE found that I had a uterine septum. A uterine septum is a fibrous band of tissue that splits the uterine cavity in two. It is the result of a developmental abnormality while in-utero. The septum started at the top of the uterus (the fundus) and reached down to the uterine opening (the cervix). The septum does not have a normal blood supply. In my case I had a rather large septum. The larger the septum, the more likely it will interfere with pregnancy.

On 9/25/05 I had a surgical procedure called hysteroscopic resection, in which my RE cut out the septum with a laser that he said would cut through the septum "just like butter"(umm...yummmm... cutting butter has never been the same since.) After the surgery he inserted a catheter(like a little balloon) into the uterus to prevent the separate walls of the uterus from joining again with scar tissue. I had to leave this in for a week. If I stood all the way upright it was as if someone was stabbing me with a dull kitchen knife in the stomach. I also took estrogen to speed healing. I thought about getting a sign to wear that said "Caution, woman on synthetic hormones, speak to at your own risk"

After surgery my RE greeted me in the recovery with the opening statement: "You have the widest uterus I've ever seen!" Riiight...is that a compliment or an insult? ....And what the hell did he expect from these Latina hips?

I also got a surprise secondary condition dx. Endometriosis (tissue that looks and acts like the lining of the uterus grows outside of the uterus in other areas). But "no worries!", my RE said, he cleaned it all out during the septum surgery. Wow two birds, one stone. I sure did get my PPO's deductible worth!

I had another m/c 1/06. I believe is was due to a car accident where an uninsured suspended driver's license m-fer was traveling for work and hit me on the 110 fwy when I was at an almost complete stop in traffic. But that's being disputed by everyone but me it seems. It's a long story, I won't bore you with the details now. So anyway, in June 2006 I went to see my RE to get an all clear to ttc (try to conceive) again. The RE found that I now had scar tissue in my uterus. This came as no surprise. 1 major surgery and 3 d and c's...a girls' uterine lining can only take so much scraping. So it was off to the surgical room again, this time for scar tissue removal.

I now have the most nip and tucked uterine cavity in LA.

After the surgery, we had no luck in getting pg for 10 months. During this time period I had a few things checked out. Basically this is how the conversations with my highly out-of-pocket- paid RE went:

Norina:" I read an article on the Internet about natural killer cells. Can I be tested for this?"

RE: "Sure"

Norina: "I read a post on a chat room about MTHFR factor. Can I be tested for this?"

RE: "Ok"

Norina: "I think I need to have an HSG to check my tubes"

RE: "You haven't had one before?"

Norina "Nooo"

RE: "Oh ok"

I had an HSG done in March. It's a test where the radiologist shoots dye into the uterine cavity via a catheter (think pouring alcohol on a 12 inch deep wound....then multiply that pain by 10000!). If the dye flows through both fallopian tubes then your tubes are clear and there is no concern that your eggs aren't getting through.

My right tube did not allow for the dye to flow through. I have a blocked right tube. In case you're counting this is defective abnormality #3.

RE's response: "Well you still have the left tube. And that test isn't all that accurate. Sometimes the tube will cramp due to the pain making it seem as if it's blocked when it's really not"

Thanks I went through an extremely painful procedure it seems for shits and giggles.

Another conversation:

Norina: "What do you think about acupuncture, I've been reading a lot about how it can help infertility"

RE: "Well Western Medicine doesn't really support acupuncture but it's gaining more favor. If you want I can refer you to one, she's wonderful."

Norina: "Yes please"

I started acupuncture with the most fabulous woman in La Canada in April. She is a God send. And a wealth of info. More then the RE, but that's not really a compliment, but more then the Internet! Now that is a compliment!

I read the book "The Infertility Cure" and started a diet of no carbs, no alcohol, no caffiene, no fun.

I read a book called "Inconceivable" and got inspired to have a colonic. I ended up getting 3.

I woke up one day with a stiff neck, saw a chiropractor and he started adjusting my lower back which is known to improve fertility.

In July I was tested for MTHFR. I know this looks like it says "Mother F*&%er" and really I think the medical community should just give in and let us call it that, but what it stands for is
Methylene-tetra-hydro-folate-reductase. MTHFR is an enzyme found in the cells of our body. Everyone has them. It is needed to metabolize homocysteine, an amino acid found in the proteins you eat. Elevated homocysteine levels have been associated with fetal neural tube defects (i.e., spinal Bifida) and miscarriage. An elevated homocysteine level can also indicate an increased risk factor for blood clots, arteriosclerosis (hardening of arteries) and strokes in both men and women. The metabolism of homocysteine depends on several enzymes, one of which is MTHFR, along with B vitamins and folic acid. In other words, B vitamins, folic acid and MTHFR are necessary to keep homocysteine levels within normal limits. Sometimes your MTHFR has a genetic defect, like mine. These defects are fairly common and its estimated by some studies that up to 60% of the population have one MTHFR mutation or another.There are two common genetic MTHFR mutations. If you have one mutation only, you are heterozygous. It is reported that nearly half the population is MTHFR heterozygous. So essentially, nothing abnormal. If you have two copies of the same mutation, you are homozygous. Homozygotes can have elevated homocysteine levels in maternal blood and amniotic fluid. If you have one copy each of the two different mutations, you are considered compound heterozygotes( ME, ME, ME!!! Mine is called "compound heterozygous for C677T and A1298C mutations"...) There is no cure but you can, however, lessen any risk factors by taking B vitamins, Rx strength Folic acid, baby aspirin, and Lovenox or Heparin (blood thinners).

During this test for MTHFR I was also tested for something called Natural Killer Cells (NKC). Twelve percent of women with recurrent pregnancy losses (3 or more) and 35% of women with 3 or more IVF failures have elevations in NK cells. Natural killer cells are one of the oldest lymphocytes (white blood cells) in man. They have many functions. One of these functions is to produce a cytotoxic chemical called tumor necrosis factor (TNF). This is a chemotherapy drug that kills cancer cells in our body. In some women (again, ME ME ME!), the embryo is misinterpreted as a cancer cell and when pregnancy is initiated, the Natural Killer cells of the woman increase in numbers and in killing power. Subsequent pregnancies fail early because of this activation. The embryo is damaged just as a cancer cell would be, by the tumor necrosis factor. The "normal" number of NKC's is under 15. Mine was at 19.

Subsequent conversation with RE:

Norina: "Should I have my homocystine levels checked"
RE: "Good idea"
Norina: "How about doing something called an immunoglobin panel? A lady I know online mentioned this to me."
RE: "Ok"

So "we" get these last two tests results done. On August 16 I call in for my results. Both are "normal" (at last something is normal about my abnormalities!).

Final score 5 infertility factors!

August 19, I find out I'm pg.................

Miracles do happen. God does exist. Could this be it? Could we be at the end of this long awaited road at last? I dare to hope....

Monday's appts will tell us a lot. For once in my life, I can't wait for Monday!!!