Thursday, February 18, 2016

You too, uterus?!


     For an entire year now, since the dawn of our time at the RE, I have sung my praises far and wide for my uterus. Specifically, my endometrial lining. My lining has been the shining star of my reproductive system. It builds up like a champ and reliably puffs up to its desired thickness like a deliciously tempting pastry, it develops a trilaminar appearance with ease, and has been complemented on by many a reproductive specialist.

     Recently, my uterus, as a whole, has been taken down a notch by the identification of a Narbothean cyst by Dr. KKs people, and by finding out that my uterine blood flow was less than stellar. However, the nail in the uterine coffin came when I received my EFT results.

     My lining has failed me and I need to enter a lupron-induced menopause for three months before my next transfer.

     Gone are the days of endometrial superiority. My lining can now retreat back to the Island Reproductive Organ Misfits with the rest of my lady parts. 

     According to Dr. Wang, we did the EFT due to my endometriosis diagnosis because studies have suggested that women with endo have a higher chance of having a dysfunctional endometrium, which can negatively impact the implantation process. My results showed the receptivity of my endometrium to be decreased. To explain it further, Dr. Wang said that the endometrium is largely composed of two components - the stroma and the glands. The stroma is like the scaffolding of a building that holds up a structure while the glands are the structures embedded within the stroma that are important in the implantation process. Basically, the stroma and glands harmonize in response to the hormonal changes throughout the menstrual cycle, which allows the endometrium to prepare for, and accept, the implanting embryo during the "window of implantation."

     From my EFT, it appears as if the glandular portion of the endometrium showed delays in development, which may affect its ability to allow the embryo to implant. This specific issue is called Glandular Developmental Arrest (GDA). This was determined during the EFT analysis when they went to look for a protein in the glands called cyclin E. Normally, cyclin E is present 5-6 days post ovulation, however, to prepare for implantation, the levels should drop low. High levels of cyclin E would suggests that my endometrium did not develop properly to allow for effective implantation. Normal cyclin E levels should be less than 20%, and ideally less than 10%. Mine came in at 30%. 

     High levels are normally caused by endo, hydrosaplinx and/or an endometrial infection. I've had enough things shoved up, around and into my vagina and uterus to rule out hydrosalpinx, and I have endo, so, yup. Therein lies the reason. 

     I also have high neutrophil levels which is indicative of an endometrial inflammation, which is also common in endo. 

     Naturally, I asked a few questions about this whole situation. I asked if my chemical pregnancy was a "good" sign and he said that it was, but that repeated chemicals are, in his experience, a common presentation of this lining problem. We can also treat for an endometrial infection but the possibility of that is low, and that, the success rates associated with the three months of lupron are exceedingly high. 

     So, that's that. We can now add my uterine lining to the list of fucked up reproductive pieces. For now, I'm hoping beyond hope that my oves yield a few good eggs (& embryos!) to transfer in May. So.Far.Away.

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