Our last blog post detailed a successful isthmocele repair surgery that will hopefully lead to a healthy pregnancy. Today’s post is a little different.
Here is a case where surgery, performed by another surgeon, had failed. The patient, Lindsey*, was still symptomatic with fluid in the cavity. Dr. Miller provided the patient with a new medical protocol, avoiding a second surgery.
Read Lindsey’s story to find out the result.
After almost four years of struggling with secondary infertility, I was fortunate enough to discover Dr. Charles Miller and the Advanced IVF Institute. I had been diagnosed with an isthmocele, which was a defect in my cesarean scar that was leading to fluid accumulation in my endometrial cavity. Just reaching the diagnosis of an isthmocele and the potential impact it could have on my fertility had taken many years. I was exhausted, frustrated, and unsure if I would ever have another child. My local physicians seemed to be at an impasse. Despite having my isthmocele surgically repaired, I was continuing to develop fluid which was impairing the ability of my physicians to transfer any embryos.
After contacting Dr. Miller, I knew it was the right decision. He was very resolute in the forward management of my situation. He did not recommend a repeat surgery to repair the defect that had not been successfully repaired. This was initially surprising to me! Repeat surgery seemed to be the obvious decision, but his thoughts were that possibly changing the protocol for my Frozen Embryo Transfer (FET) would decrease the amount of fluid I was producing.
When transferring frozen embryos, the usual protocol is to use estrogen and the route can vary (i.e. oral, patch, intramuscular). The patient then adds progesterone prior to the transfer. Unfortunately, in my case, the estrogen caused a build-up of fluid, particularly with the isthmocele.
Due to his extensive experience in this matter, I trusted Dr. Miller’s judgment and I am so thankful that I did. After two previously canceled FET cycles with other protocols, I followed the protocol set forth by Dr. Miller on my third attempt.
The protocol that he recommended, and he said was successful on many occasions, is that rather than utilizing estrogen initially, the meds are used to stimulate the ovaries so that my own estrogen levels rise. Thus, taking away the need to utilize estrogen.
I am ecstatic to say that it worked and I am eternally grateful to Dr. Miller and his staff. We are set to welcome our miracle in May 2018!!
-Lindsey
*Name changed to protect patient privacy