A war with many battlefields: Introduction to a gynacological horror show - or so it feels

So, lovely internet, here it comes. My own personal gynacological horrorshow.

At times my struggle with infertility seems like a war with many battlefields; some of which that may still lie in the dark (though I’m hoping not). At this point, almost all my reproductive organs have taken a beating: ovaries, fallopian tubes, uterus, and cervix. It’s not hopeless, yet, but it does feel like I’m sitting on a minefield that can go off any time – or has already done so.

1. Battlefield: Endometriosis
I was diagnosed with endometriosis when I was 29 years of age. I was single at that time and not trying for a baby. At first, it looked like my endometriosis had spared my reproductive organs and had mostly just taken a liking to my bladder (of all places, and just for the record: it grows outside and inside my bladder). But we were wrong. In fact, these days (now that I know I’m infertile) my RE, to be referred to as Dr. Soothing, even uses the plural form when speaking of my endometriomaS that have taken residence on my ovaries. And these ones are not the first. I’ve already had one removed from my left ovary via laparoscopy a couple of years ago before my pregnancy with Miss V who we luckily conceived relatively effortless despite all this endometriosis shit (and out of that left ovary no less).

Dr. Soothing considers my current endometriomaS our primary reason for not getting pregnant again. He also thinks that these lovely chocolate cysts were probably already in place before we started “trying” for our elusive second child. But I don’t get it. I really thought after 9 months of pregnancy (= no periods) and a year of nursing (= another year of no periods for me), I should have been in good shape?! Alas, not so much. According to Dr. Soothing, I seem to have a particularly severe/aggressive form of endometriosis, one that grows regardless of treatment. Or pregnancy.

2. Battlefield: Partial Uterine Rupture
It’s sort of difficult for me to admit to an infertility community that I still harbor some anger about what happened at Miss V. birth. After all, not only was I able to get pregnant and stay pregnant, I also was able to go home with a beautiful baby girl. And beautiful she was and still is. Nevertheless, it still boggles my mind that the incredibly unlikely complication of a uterine rupture happened to me. Nobody knows why it happened, although I have some hypotheses of my own. My regular gynecologist, Dr. BadNews (for that’s what I associate her with), claims I have a “weak” uterus. Weak uterus?! WTF is that supposed to mean?

As far as I know the partial rupture should not have any impact whatsoever on conceiving again. It does however have implications for future pregnancies: 1) a future pregnancy would be high risk, and would require a C-birth sometime before the duedate should we be able to make it thus far. 2) At least Dr. BadNews thinks I should only attempt to have one more child. This last bit of news was depressing when I heard it because I felt ripped of a “choice.” Haha, now that having this “one more child” is such challenge, I can’t remember anymore why I was so depressed about the news in the first place. 3) Should we be able to attempt IVF, and get to transfer, we may not be able to transfer more than one embryo (if there are more in the first place), thus reducing our chance of a future pregnancy.

It sucks.

3. Battlefield: Cervical dysplasia
Sometime last year after almost one and a half years of no period due to pregnancy and nursing, my period returned. And so did my bladder pain caused by endometriosis. Honestly, I never expected anything else. Sure, I was hoping that maybe pregnancy would have changed things for the better as apparently it does for some women, but I really didn’t expect it (unlike one of my best friends who like so many people uninitiated in endometriosis think that pregnancy is a cure. Let me tell you, it’s not).

When my endometriosis symptoms returned I made an appointment with Dr. BadNews who I hadn’t really seen before. During this appointment, we talked about another pregnancy and she delivered the somewhat depressing news about “only attempting one more due to my weak uterus.” During the same appointment, I also asked for a pap smear.

Pap smears had thankfully never been an issue for me before my pregnancy and I didn’t really expect them to be a problem now. And after not hearing from my doctor for almost three weeks, I pretty much thought things were okay. How wrong I was – yet again.

My pap smear turned out bad, very bad. Apparently, I’m a carrier of the HPV virus*. According to Dr. BadNews with the degree of abnormality seen in my pap smear, cervical cancer was pretty much a certainty, if not already then in the future. I had my biopsy (at which I yelled at my doctor to never use the term “hysterectomy” in my presence ever again. I really did. Poor Woman. But then again she was the messenger of bad news...) done a day before we were supposed to spend a beach vacation with Mr. H’s family. That vacation was sort of drowned in tears while waiting for the results. Although not very likely, Dr. BadNews hadn’t ruled out cancer quite yet.

When the results finally came in (and it took longer than it normally takes – how reassuring), they were thankfully much better than expected. To all our surprise the degree of “severe” abnormality was downgraded to “mild.” Nevertheless, Dr. BadNews recommended a leep procedure to get rid of the abnormal tissue. And so we did. If you have never had this procedure done, let me tell you, it’s quite a sight to see one’s vagina smoking…

Rationally I know that pap smears are a good thing for women**. But I am now scared of them. I just couldn’t afford anymore procedures that shorten and weaken my cervix. Not now, not before I have my second baby. I already have dysfunctional ovaries and a broken uterus. Is there no end to this?

* if it is true that only promiscuous women get HPV (and cervical dysplasia), I must have had a far more exciting sex life than I am aware of. What bullshit. Any woman who has ever had sex with men – may it be only one time (I also know one lesbian woman with HPV. No kidding.) can get this virus. Men, too, of course. It just doesn’t hurt them.

** there may be great help for my daughter’s generation: a vaccine against the HPV virus that protects them almost, if not, 100%! Miss V. is definitely going to be vaccinated. No question about it.

4. Battlefield: Aging Ovaries
After my leep procedure, I was set on getting pregnant again soon. I was 34 and I was desperate. I wanted to be pregnant before my next pap smear so badly…Well, we all know that didn’t happen.

Month after month went by and each month I got my period. Blablabla. You all know how it is. And you all know where I went from there. After a year, now 35, I subjected myself to the care of an RE, Dr. Soothing.

Given my endometriomaS and all that shit, he told me right away that he thought my best chance would be IVF, if, of course, my ovaries hadn’t given up quite yet. During a very stressful cycle, it was determined that my ovaries were a bit old, but not too old yet. My FSH, though close to the magical 10, had not crossed that barrier yet. Although Dr. Soothing didn’t seem too concerned about my FSH, I am now working with my acupuncturist* to “lower” my FSH. Gosh, can a girl not get a break?

* My infertility employs a whole arsenal of different professions

5. Battlefield: Asherman’s Syndrome
Remember that birth complication that I still feel sort of angry about? Well, part of the anger results from the fact that not only did I have that super unlikely (and unlucky) uterine rupture, I also ended up in the unlikely category of getting Asherman’s from that c-birth.

Asherman’s syndrome refers to any kind of scarring/adhesions in the uterus. It is caused by uterine surgery and infections (I think). It is also rare. Asherman’s can cause thin uterine lining, it might make it difficult for an embryo to implant, and it might cause miscarriages. It can also block fallopian tubes (which it did for me on the right side). It sucks.

Apparently, I signed up for it.

All this makes one wonder how my body ever managed to get pregnant and give birth to Miss V., doesn’t it? Well, at least I wonder. I will be forever grateful that I have my little Miss V. If I had to go through her pregnancy and birth again and again to get her out safely and soundly, I would in a heartbeat. No question about this.

…But I nevertheless have a hard time digesting all my unlikely reproductive complications. Why does every part of my reproductive plumbing have to be bruised, often several times?

I admit that I am/ was a tad bit depressed about having endometriosis. But I try to think “shit happens. And that’s the shit that happened to you. Deal with it.” And I accept that I have endometriosis. I really think I do. Things could be much, much worse (people tell me this a lot, but really they don’t have to. I’m pretty sure I know this myself). I even sort of accept that I suffer from infertility as a result of it (although I admit, that is much easier to do when you already have a child). Long before even trying to conceive my first baby, I tried to prepare myself and Mr. H. for the likely reality of IVF some day (but then was awfully glad that Miss V. didn’t require it). But I have a hard time grasping the rest. It’s just too much. If all these assaults to my reproductive system are supposedly unlikely and random, how can they have all happened to me? It boggles my mind. Somewhere along the way, something inside of me has shattered and I am not sure it will ever be whole again. Is it any wonder that I feel like a gynecological horror show?

By the way, we have never had Mr. H. tested yet. Any chance this may all be “his” fault? Haha.