Ok so as some of you may be aware. I am five weeks late for my period. I went to the doctor and urine tests indicated a BFN. Then today i went for an ultrasound. The doctor kept writting Uterus seperated at fundus. What does it mean. Whats could be wrong. Please help me
Hi! It sounds like you have what is known as a "Mullerian Anomaly" - which is just a fancy way of saying your uterus is a little different than what they usually see. I'm a moderator for a Yahoo Groups board for women with Mullerian Anomalies - or "MAs" for short - you're welcome to come for a visit!
The uterus (and fallopian tubes and cervix and lower bit) originally start off as 2 separate tubes - one on the left, and one on the right. When you were a developing fetus, the parts that ultimately form the uterus and the cervix and the lower bit are supposed to fuse together to form that pretty picture you see on your gyno's wall. Sometimes, though, the two tubes don't fuse together entirely, and leave some degree of separation or "left-over" tissue down the center that didn't get absorbed the way that it should.
There are 2 possibilities that occur to me from reading "Uterus seperated at fundus". One is that you have a uterine septum - aka a "septate uterus" ("SU"). You may be familiar with the term "nasal septum" or "deviated septum" - it's the little cartilage that's in your nose. However, your nose is SUPPOSED to have a septum - your uterus is not!
An SU can range from something as simple as a little "ridge" that runs across the top of your uterus from front to back, to a full piece of tissue dividing the uterus into 2 chambers, left and right. Although the risk of miscarriage can be quite high with a septum that is substantial (i.e., a septum longer than 2 cm from the top of the uterus), there is a very, very simple and effective surgery to remove it, and brings the odds of miscarriage pretty close to that of a "normal" uterus.
The other possibility is that you may have a "bicornuate" uterus ("BU") - this just means that at the top of the uterus, instead of having a single, rounded space, that there is a dip at the fundus. This can range in severity from a small "dent" on the top, center portion of the uterus (some docs consider this a variant of normal) to a very noticable separation at the top (think Mickey Mouse ears). Generally, surgery is not called for even in the case of severe BU becuase BUs generally have a pretty good pregnancy outcome.
So. . . sounds like you need to find out what you have, and the severity of it. The one thing that I have to caution you about is that a lot of docs REALLY don't know what they're talking about when it comes to MAs - they confuse terms, don't know the current standard of care, etc. (Hey - sounds like how a lot of docs treat PCOS!!!!)
The BEST and most definitive way to diagnose what you have is a combination of laparoscopy and hysteroscopy (simple day surgery). Ultrasounds are great at telling you that you have a problem, but are notoriously bad for showing whether you have BU or SU - and lots and lots of women are misdiagnosed via ultrasound.
The other really popular (but totally inconclusive test) is an HSG - where they shoot dye into your uterus and take x-ray pictures. Also really good for showing that you HAVE a problem, but terrible for telling you WHICH problem it is. Please, please, please don't let your doc make a diagnosis on the basis of an HSG - it doesn't show the exterior contour of the uterus, and therefore, can't be used to distinguish between the two.
Finally, an MRI can be a good diagnostic tool, but only if it is both DONE right, and READ right, and sometimes, the combination can be hard to come by!
hth,
dk
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Wow... thanks for all the information. I did have a laperoscapy a few years ago that was fine. So this is something that has occured over the past 3 years or so.
If the laproscopy did't note that you had anything unusual with respect to the exterior of your uterus, it strongly suggests that you have SU. You might want to try to get ahold of the operative notes / operative report from the procedure to see if they examined your uterus and made any comments. You should know, though, that depending on what they were in there for, they may not have even *looked* to see what your uterus was like!
So. . . if you have a normal appearing uterus from the outside, then you have a septum. This would not have happened recently, as the fusion defect occurs while you were still a fetus. It's always been there, but either nobody noticed it before (happens all the time), or someone noticed and forgot to tell you (also happens all the time).
Like I said, this is actually good news - if the septum is big enough to cause any problems, it is easily fixable (and a good doc will want to fix it before telling you to go ahead and try to get pregnant and "see what happens").
A LOT of docs say that septums don't cause fertility problems, but I think that is slowly changing. I know a lot of women who were never able to get pregnant before having their septum removed (or who were constantly having chemical pregnancies) who only successfully became pregnant after their septums were taken care of.
The other thought that I have is that you may have an intra-uterine fibroid at the fundus (top of the uterus). This could cause the interior cavity to appear to have a dip in it. It's rare, but it does occassionally happen that a fibroid in this location is mis-diagnosed as an MA.
Regardless, you want to make sure that you find out DEFINITIVELY what's going on in there. I had a botched diagnosis (that I had a different type of anomaly that wasn't operable) that cost me 2 years of TTC time - and as a result, made me cross that "magical" line of 35 years old before I could get pregnant. This doesn't seem like a lot, but there are a lot of issues of being "of advanced maternal age" (eww) that I could have avoided with a correct diagnosis.
PM me if you would like to join the MA group (lots of really knowledgable and compassionate women there!) and have any difficulties finding it / signing up.
Good luck!!
dk
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You're going to think I'm crazy (and probably repetitive ) when I say this, but that is GREAT news. Were they able to tell you how big the septum was? It is very, very easily fixable.
If you need any information on choosing a doc to take care of it (the yahoo group for women with uterine anomalies maintains a pretty good list of qualified docs), or the surgery itself, let me know.
dk
previously had a complete SU - resected in 2/2007
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I do actually have a great fertility doctor in my local area. He has been featured in articles and newspapers for his knowledge. I have gone and seen him once before. So i will be going back to him. The doctor (OBGYN) did not inform me of its size but told me that it may or may not affect a pregnancy. She said that its easily removable and that if i do try to get pregnant and happen to miscary then i should look towards surgery. Which i may end up doing just to get it over with, depending on the risks.
Help me please 
) when I say this, but that is GREAT news. Were they able to tell you how big the septum was? It is very, very easily fixable.
