Mistaking the cervical canal for the uterus

[SmileyStar]

Stenosis(tightly closed) of the cervix has, so far prevented the transfer of a day 5 embryo(early blast) from being transferred to the uterus. A hysteroscopy was done to dilate the cervix to gain access to the uterus. Unfortunately, the Doc that we were referred to diagnosed my DW with severe Asherman's syndrome. Basically he didn't see any kind of endometrium(lining), and the uterus according to him is severely affected with adhesions(walls are grown together), he attempted to reopen the uterus by cutting the adhesions to restore the uterine cavity and a catheter was inserted to prevent the walls from growing back together.

*Background*
DW had a large fibroid that was attached to the bottom of the uterus and along the cervical canal. This was removed with an abdominal myomectomy a little over a year ago This fibroid caused the uterus and the cervix to become distorted unusually long.

Basically the uterus can be thought of as a room and the cervix is a hallway with two doors. One door leads to the uterus and the other door leads to the vagina. my DW's hallway is shaped like L, the long straight portion is attached to the vagina then it makes a 90 degree turn down to the uterus.

Severe cases of Asherman's the lining is replaced by adhesions and AF just doesn't happen, because there isn't lining or the uterus/cervix are sealed shut by the adhesions so there is no period. DW has normal periods. Lining looks normal on U/S. So were did the Asherman's diagnosis come from. Our RE attempted to get the catheter into the uterus but the catheter couldn't get through the short part of the L connecting to the uterus. We have an MRI next week to confirm what our RE and I think happened.

We think that the Doctor that performed the hysteroscopy entered the long straight hallway, got lost, and mistakenly thought the 90 degree turn to get to the second door was a fallopian tube. He then proceeded to widen the hallway by cutting into the muscle. He didn't make the turn to go into the uterus.

There are two possible reasons the catheter can't get into the uterus: 1. The door to the uterus is still closed because it wasn't dilated. 2. The catheter is getting stuck in the hallway, where the muscle was cut.

How that Doctor got lost is mind boggling...

 

[hopeforamirac]

wow what a rubbish situation
i really hope you get answers soon

 

[flashy09]

Do you have any updates? What a horrible situation!

 

[SmileyStar]

We just had our transfer, DW was given propofol and put to sleep on Friday. We have our beta on Nov 1st. The widened hallway made it difficult to navigate the cervix but ultimately the doc was able to put the embryo where he wanted. Lining is nice and thick so hopefully the embryo will make itself at home for the next 9 months. DW will be resting most of the weekend.

 

[itsnowmyturn]

Fingers crossed for u xx

 

[3chords]

I was going to say I doubted he'd have cut through the muscle because your wife would have experienced great pain afterwards and also the muscle would grow back together.

I have a retroverted uterus and the techs and some docs ALWAYS have a problem getting the catheter through my cervix. It can be very painful.

The only time they've had no problem was during my (numerous) hysteroscopies, it helps a lot when the hysteroscope is going in as it has a camera built in, so the doctor really can't make an error in turning in, etc.

Best of luck to you!

 

[SmileyStar]

That was a possibility that the hysteroscope made it to the uterus, but during the transfer it was confirmed that they had created a false passage, as the catheter was seen going in the wrong direction. You'd think that the camera would prevent mistakes, but if you have to cut your way through the cervix and mistake the internal os for a fallopian tube. Dw's cervix is much longer than a normal one from the previous fibroid. I'm also pretty sure that doctor didn't use ultrasound guidance either during the procedure.

I was going to say I doubted he'd have cut through the muscle because your wife would have experienced great pain afterwards and also the muscle would grow back together.

I have a retroverted uterus and the techs and some docs ALWAYS have a problem getting the catheter through my cervix. It can be very painful.

The only time they've had no problem was during my (numerous) hysteroscopies, it helps a lot when the hysteroscope is going in as it has a camera built in, so the doctor really can't make an error in turning in, etc.

Best of luck to you!

 

[SmileyStar]

4dpt 5dt brown spots this morning. Encouraging sign our embryo is in the process of implanting.

 

[itsnowmyturn]

Exciting stuff!!!

 

[SJsmom87]

Best of luck to you two!!

 

[mummy4kids]

Good luck.xxx