Inflammation? Mucous?

PiperD

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Reply Inflammation? Mucous? Posted on: Aug 12, 2011 at 8:02pm
I had two miscarriages last year. The second one required two D&Cs due to RPOC. This led to scarring of the cervix, which required two hysteroscopies (ERT and balloon stent) plus dilations to fix it. Throughout this entire year of surgeries, etc, I have had a fluid or mucus appear in my uterus after my period until ovulation. Originally we thought it was leftover menstruation since my cervix had been scarred/narrowed. But after a recent HSG showing clear tubes, no scarring, open cervix, and normal uterine cavity, we know that it is not my period backing up, but it is a fluid or mucus of some type. Nobody has sent it for testing and everyone keeps acting like, oh well, this is now how your lining reacts, but the problem is, this is NOT how my lining reacted BEFORE my botched D&C with RPOC and scarring. What could be causing this fluid/mucus to come around CD 5 or 6 every month? The docs are acting like it's no big deal but I have had to cancel multiple FETs because of this. We just went through with one even though I knew my uterus was not ideal only to get a negative result, wasting two of our frozen embryos. Not only am I concerned about not being able to carry a pregnancy again, but I am concerned about WHAT is causing this - what to me looks like - inflammation of my lining? I was monitored monthly for a over a year before my second miscarriage and never had any problems with my lining, always grew thick and never any fluid. Now my estrogen increases to like 600 before I ovulate, my lining doesn't get past 7mm, and I have this mucousy fluid in my uterus. What do I do? Could the months of retrograde menstruation and estrogen therapy have caused endometriosis? Does this sound like an immune response of some kind?

I am compound heterozygous for MTHFR. No other clotting problems. Autoimmune disorders run in my family (colitis, psoriasis, excema, allergies).

I have spoken to your staff about possibly setting up an appointment but I wasn't sure if I am barking up the wrong tree. Please tell me your opinion.

Thank you.

Dr. Braverman

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Re: Inflammation? Mucous? Posted on: Aug 13, 2011 at 12:19am
The development of "fluid" or "mucous" during a stimulation cycle is not unusual. Causes that should be ruled out are fluid leaking down from the tube, a "serous" exudate as a result of tissue injury, inflammation, very high estrogen levels, blood(break through bleeding).
Its hard to say if this is a result of a D and C. Certainly as its a blind procedure its also hard to speculate that it was "botched" as sometimes this can happen in the best of hands.
I would certainly want to study the fluid, culture it, gram stain it, to see what it is.
I have on occassion aspirated the fluid just prior to an embyro transfer and had success.
sometimes its not the fluid but other issues preventing implantation. The fluid does not sound like its immune related , but the failed cycles could be. I do suspect this to be more of a mechanical issue than an immune issue. At least aspirate the fluid and test it so we can see what it is.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

PiperD

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Reply Re: Inflammation? Mucous? Posted on: Aug 13, 2011 at 4:25pm
Thank you for your reply. And just to clarify, this is happening during NATURAL cycles, not medicated. We first thought that the stimulation was the cause, but have since stopped any medications and the last two completely unmedicated natural cycles have resulted with this same "fluid." It is also not due to high estrogen levels as it begins to appear while my levels are in the 50-100 range. It is also not blood as when it has been aspirated it appears to have a "mucousy" look about it. Also, the reason I refer to the D&C as "botched" is although I understand it is a blind procedure, my doctor was supposed to check on ultrasound after to see if there was anything remaining and she failed to do so properly. The next ultrasound showed clear remnants of remaining tissue/placenta/whatever and caused me to need another one, resulted in a slew of problems. Prior to all of this drama, I had gotten pregnant very easily and it was only a matter of getting pregnant with a healthy embryo. Now I have my uterus to contend with and it has been an emotionally draining process. My main concerns are that I do not get a thick, triple stripe lining like I did before all of the surgeries. I have been ovulating a week later than normal and my estrogen level has been getting much higher than it did before. I have this "fluid" and don't know the cause. I suspect there is something wrong with the lining/endometrium itself but nobody seems to want to find out what it is.

PiperD

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Reply Re: Inflammation? Mucous? Posted on: Aug 13, 2011 at 4:35pm
Also, I spoke with your office and your appointments are three weeks out at the time. I only have this fluid during the first two weeks of my cycle. Would it be possible to squeeze me in this month while the fluid is present so I wouldn't have to wait another whole cycle to get this problem looked at?

Thanks again.

Dr. Braverman

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Re: Inflammation? Mucous? Posted on: Aug 16, 2011 at 1:10pm
yes please call the office and tell them to just schedule you for a sonogram not a consult and come in at the time you think is appropriate.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.