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Fertility / Infertility (Expert Forum)
substantial uterine septum
Answered by
Elaine Brown, MD - Pregnancy, Gynecology
Elaine Brown, MD - BLOG
Billings - MT
Questions in the Fertility/Infertility forum are answered by doctors affiliated with USF Health. Topics covered include fertility or infertility issues, egg quality, fertility drugs and side effects, fertility tests, genetic testing, in-vitro fertilization (IVF), ovulation, relationship issues, risk factors, sperm count/quality, and surgery.
substantial uterine septum
by Scout0809, Jun 14, 2009 10:48PM
I recieved an ultrasound for pain and found that my ovaries were fine except they found something that look like a bicornuaous uterus or a septum.
Went for the MRI and found of that I it was a uterine septum containing muscle and fibrous tissure at the fundus with a thin fibrous band extending the entire length of the uterine endometrium to the internal cervical os. The outer fundal contour of the uterus is only slightly indented. There is splaying of the endometrial cornu but an intercornu distance of 3cm.
I was ref to a RE specialist and found no awnser.
I dont use birth control for at least 7 years or more and I do want kids. Im engaged and been with him for 5 years and im 25 all most 26.
My queston is,,, I have Hashimoto's disease w Hypothyroidism and now I have this large septum and my Gyn doc is consern with pre mature labor and a specialist who tells me that there are many women who get pregnant.
I dont know what surgery I need, what it involves, would it be benifit me to get surgery and when can i get it done? What risk involves and with out it having surgery, what would happen if i did get pregnat if surgery was not preformed. The RE specialist said come back to him when i was ready to have kids. I just need consultation. Do i need to have miscarrages,married or loss of child due to pre mature labor in order to seek help for this problem? I dont even know my chances or who to go to next. I want to get awnsers while i still have a job and insurance. I work 10 hour days with no breaks while standing and im always fatigue and sleep alot. Is this too much stress if i do become pregnant and try to work at the same time. Why wont they help me with this septum?
Went for the MRI and found of that I it was a uterine septum containing muscle and fibrous tissure at the fundus with a thin fibrous band extending the entire length of the uterine endometrium to the internal cervical os. The outer fundal contour of the uterus is only slightly indented. There is splaying of the endometrial cornu but an intercornu distance of 3cm.
I was ref to a RE specialist and found no awnser.
I dont use birth control for at least 7 years or more and I do want kids. Im engaged and been with him for 5 years and im 25 all most 26.
My queston is,,, I have Hashimoto's disease w Hypothyroidism and now I have this large septum and my Gyn doc is consern with pre mature labor and a specialist who tells me that there are many women who get pregnant.
I dont know what surgery I need, what it involves, would it be benifit me to get surgery and when can i get it done? What risk involves and with out it having surgery, what would happen if i did get pregnat if surgery was not preformed. The RE specialist said come back to him when i was ready to have kids. I just need consultation. Do i need to have miscarrages,married or loss of child due to pre mature labor in order to seek help for this problem? I dont even know my chances or who to go to next. I want to get awnsers while i still have a job and insurance. I work 10 hour days with no breaks while standing and im always fatigue and sleep alot. Is this too much stress if i do become pregnant and try to work at the same time. Why wont they help me with this septum?
Doctor's Answer
by Elaine Brown, MD, Jun 17, 2009 12:17AM
, Jun 17, 2009 12:17AMTo: Scout0809
Hi!
I think that you SHOULD definitely pursue the issue while you have insurance coverage. HOWEVER, many infertility problems are not covered by insurance, so even if you DO have health insurance, you may not be able to convince them to pay. They are much more likely to pay for pain-type issues, so you may want to take that approach.
Many women with uterine septa do have endometriosis and painful periods, so if that applies in your case, you may wish to emphasize that to the doctor. I would definitely suggest that you have a RE do your surgery as opposed to a generalist, too.
There is no need to be married, but it is certainly a plus that you are in a stable relationship.
There are two main ways to remove a septum. The first is by using a resectoscope/hysteroscope. This is all done vaginally, and is the preferrable type of surgery if it is possible to do in your case. There is also a procedure called a Metroplasty, which involves an incision in the abdomen, and is a major surgery. If the septum is not removed, you are at risk for miscarriage and preterm labor as well as malpresentation (the baby comes out feet or bottom first instead of head first).
Many women with septa DO conceive and deliver. Some never even know that they have a septum. If you do have the septum removed, you will still be at higher risk for these problems, so, sometimes women are advised to go ahead and try to conceive and deliver. In your case, it looks like to me that surgery WOULD be beneficial, but your specialist will need to make that call.
Hypothyroidism is not a big problem as long as it is treated and the hormone levels are normal. You DO want to take your thyroid hormone throughout the pregnancy, it is GOOD for the baby!
Stress can definitely impact pregnancy, and if you do become pregnant, and do develop symptoms of preterm labor, you won't be able to continue the type of work that you are describing.
I hope this is useful information for you!
Good luck!
Dr B
I think that you SHOULD definitely pursue the issue while you have insurance coverage. HOWEVER, many infertility problems are not covered by insurance, so even if you DO have health insurance, you may not be able to convince them to pay. They are much more likely to pay for pain-type issues, so you may want to take that approach.
Many women with uterine septa do have endometriosis and painful periods, so if that applies in your case, you may wish to emphasize that to the doctor. I would definitely suggest that you have a RE do your surgery as opposed to a generalist, too.
There is no need to be married, but it is certainly a plus that you are in a stable relationship.
There are two main ways to remove a septum. The first is by using a resectoscope/hysteroscope. This is all done vaginally, and is the preferrable type of surgery if it is possible to do in your case. There is also a procedure called a Metroplasty, which involves an incision in the abdomen, and is a major surgery. If the septum is not removed, you are at risk for miscarriage and preterm labor as well as malpresentation (the baby comes out feet or bottom first instead of head first).
Many women with septa DO conceive and deliver. Some never even know that they have a septum. If you do have the septum removed, you will still be at higher risk for these problems, so, sometimes women are advised to go ahead and try to conceive and deliver. In your case, it looks like to me that surgery WOULD be beneficial, but your specialist will need to make that call.
Hypothyroidism is not a big problem as long as it is treated and the hormone levels are normal. You DO want to take your thyroid hormone throughout the pregnancy, it is GOOD for the baby!
Stress can definitely impact pregnancy, and if you do become pregnant, and do develop symptoms of preterm labor, you won't be able to continue the type of work that you are describing.
I hope this is useful information for you!
Good luck!
Dr B
