Up next: laparoscopy

I had an appointment with the NaPro surgeon Dr. C this week.  My surgery is all planned out and will include: laparoscopy, HSG, and removal of a uterine septum.  He said I'll be back to work within a week.  It's a big step, but I am excited to rule out (or rule in and treat!) several diagnoses all at once—endo, open/blocked tubes, polyp, etc.

The appointment itself went well.  Dr. C reviewed the last four months of charting just in case there was anything he missed that we could try before surgery.  He said if I wanted to we could try ovulation inducers (Clomid or Femara) for 3-6 months as an alternative way to improve post-peak progesterone (by improving follicle quality you improve corpus luteum quality).  But he preferred (and I agreed) to do surgery first because it might get us closer to figuring out the cause of the bleeding...and he also wants the septum gone asap.  Usually if a septum is going to cause a problem, it would cause miscarriage, but it's possible it could be playing a role in our infertility.

Dr. C's current theory as to the cause of my crazy bleeding is possible adenomyosis (endo within the uterine wall).  I have wondered that for a while as well.  A couple years ago I even asked my non-NaPro ob/gyn if he thought I could possibly have adenomyosis when we were looking into my unusual bleeding.  (He looked at me like I had two heads when I asked that.)  I am not a medical expert but when a girl happens to own the NaPro textbook and notices that her chart looks strikingly similar to the sample chart from a woman with adenomyosis, she starts to wonder these things...  ;)  Unfortunately adenomyosis is tough to diagnosis without removing the uterus.  Sometimes if it's superficial it can be visible during a laparoscopy—there's a picture in the NaPro textbook.  Dr. C also said it can appear on MRI.  I did have an MRI last year, and the report didn't mention it...

Dr. C said it would be about three months before he could fit me in his surgery schedule.  However, the scheduler called me yesterday, and the first available date is in February!  My surgery is on 2/21—that's six weeks from now!!  It's probably good that it's scheduled so soon so I have less time to be nervous.  :)  It feels good to be making progress!