Hysteroscopy with resection of uterine septum

At my saline ultrasound, my fertility doctor saw what she suspected to be a uterine septum (an upside-down, triangular shaped piece of tissue which divides all or part of the uterine cavity in two). The septum does not have proper blood supply, so if an embryo were to implant over the septum it would likely result in miscarriage. A likely cause of our pregnancy losses. I would need a hysteroscopy, a straightforward outpatient procedure, to have it removed. First, a camera (hysteroscope) is inserted into the uterus through the cervix. A wire loop with electrical current is extended through the camera and applied to the septum tissue. As the septum is incised, the tissue springs back in the uterine wall, creating a normal uterine cavity.

I was ready. My RE started me on birth control pills two weeks before the surgery, to thin the lining of my uterus and keep me from ovulating and getting pregnant. The morning of the procedure I was to take misoprostol, to help soften the cervix. I took the pills four hours before the surgery and laid down until it was time to go to the hospital. I had been warned the misoprostol could cause cramping. Which it did. Subtle at first, but once I arrived at the hospital two hours later they started to intensify. As I was getting prepped for surgery I I became quite uncomfortable, and started counting down until the anesthesiologist arrived to give me some pain meds. My husband stayed by my side.

The surgeon (my RE), her resident, the anesthesiologist, and a few nurses scurried around me. I was given pain meds and some valium, and after a quick goodbye to my husband, was wheeled into the OR. They continued prepping for surgery, and I was soon asleep.

I woke up 2 hour later. I vaguely remember the nurses saying I had a fever, but that it was normal. I felt quite sleepy and woozy, but tried my best to talk to my RE about how the surgery went. She told me I had a sizable septum, and because of that she put in a balloon catheter into my uterus, which would stay in for five days while my uterus healed. This would prevent the walls of the uterus from touching to prevent scarring or a re emergence of another septum. She warned me it could cause more cramping.

I stayed in the recovery room for four hours, much longer than what was usual, the nurses noted often. I had become horribly nauseous, probably from a combination of the pain meds and anesthesia. They also would not let me go home without urinating. Which was not happening. Two bags of IV fluid, 3 juice cups, 2 glasses of water and 4 hours later, I finally went. After a couple “way to go!”’s and some cheers from the nurses, they let me go home.

I was very tired for about 3 days after the surgery, and it took close to a week to really feel like myself again. I had some cramping for a few days, but generally felt ok. My RE prescribed me 2mg of Estradiol to take twice a day for 28 days, and 200 mg of Progesterone to be taken for the last 12 days of the Estradiol. Five days after the surgery I went to my RE’s office for a follow up and to have the balloon removed (a little uncomfortable and weird, but not painful). Once I get my next period I’ll return to her office for an ultrasound to see how my uterus is healing. If all is well, we can start trying again next cycle.

*Update: I got my period 28 days after the surgery and went back to my RE for a CD3 ultrasound. She found a small cyst, likely a side effect from the surgery, and advised us to wait one more cycle before we started trying. My next period I bled for 2 weeks and my cycle was 39 days long, both of which is very unusual for me. When my period finally returned and I went back to the RE for a CD3 ultrasound the cyst was gone, and we were cleared to being trying again.