A double-edged sword...

Another one of my many issues is completely biological and anatomical.  After my last Cesarean section I had a hysterosalpingogram performed.  It was after this test that it was discovered that I have what is known as a "unicornuate uterus."  It's a rare and mostly congenital condition (described below).  Of course, at this diagnosis my mind went directly to the notion that it may not have been congenital at all - and may have been physical trauma from my abortion.  I'll never know the true answer to that question.

However, what I do know is why when my husband and I tried to get pregnant - it took a long time and we never really knew why.  Right before we started any infertility type treatment - I would end up pregnant on my own (well, not on my own, but you know what I mean - with no medical intervention).  After two successful pregnancies - my OB told me that had he known of my condition before those two - he would have told us to start looking for a surrogate or some other way to have children because my chances were that slim or non-existent.  He also told me it was possible that I had some miscarriages along the way that I didn't really know about.  When we went back over all of our charts from NFP - it was clear that I was not ovulating regularly or sometimes, not at all - no temperature spikes, nothing.  With only one functioning tube - now it made sense. 

I think of this as a double edged sword - because most women (those who haven't had an abortion) would look at this as a complete blessing from heaven that they had two healthy children in spite of this rare anomaly.  However, in my clouded mindset - I do reflect on what miracles my children actually are but it's colored by the idea that my abortion may have been the reason why I had such trouble getting pregnant when we wanted to.  It may also be the reason I won't be able to have any more children.  I'm too damaged and the risk is too great.

The good thing is I'm getting better at recognizing the grace and the Grace in all of it and ignoring the negative thinking...

Even with a unicornuate uterus, a non-functioning fallopian tube, etc., I have two beautiful and healthy children here on earth and one as my own personal guardian angel in Heaven.

A unicornuate uterus is a uterus that has a single horn and a banana shape. Approximately 65% of women with a unicornuate uterus also have a second smaller or rudimentary uterine horn. The rudimentary horn can be solid or it can have a small cavity with a functioning endometrium. Sometimes the smaller horn connects to the uterus and vagina, but more often it is isolated or non-communicating.

A unicornuate uterus is the least common congenital uterine anomaly and represents 1 to 2% of cases. A unicornuate uterus can be asymptomatic. However, women with a functioning non-communicating horn may experience pain during periods, because there is no outlet for the menstrual fluid. Women with a unicornuate uterus are at risk of reproductive complications. They may have a difficult time becoming pregnant because typically only one fallopian tube functions. In fact the condition is sometimes first discovered when a women undergoes an infertility investigation.

Pregnancy can occur with a unicornuate uterus, and the term pregnancy rate is approximately 47%. But women with a unicornuate uterus who do become pregnant are at risk of: Spontaneous abortion - it is thought that the abnormal shape of the uterus itself and compromised blood flow to the uterus and placenta lead to spontaneous abortion.

Premature labor - since the uterine cavity is smaller than usual, the baby outgrows the available space earlier in the pregnancy and there is an increase in breech presentation during delivery.

Surgical correction of a unicornuate uterus is not possible, as the uterus can not be enlarged. Cervical cerclage may be recommended for women with a unicornuate uterus who have experienced miscarriages or premature births. Pregnancy can also occur in a non-communicating arm. The situation is similar to an ectopic pregnancy and must be treated as an emergency. If pregnancy occurs in the non-communicating arm, uterine rupture occurs in approximately 89% of cases by the end of the second trimester. Because of this risk, surgical removal of the non-communicating arm is recommended. Removal of a solid non-functioning arm is not necessary.

Diagnostic procedures
It is difficult to diagnose a unicornuate uterus with ultrasound. The condition can be visualized with MRI, three-dimensional sonography and with laparoscopy.

Treatment
No surgical intervention is required unless endometrial tissue in a rudimentary horn results in pain or a pelvic mass or unless an incompetent cervix is suspected during pregnancy. A rudimentary horn may be excised to treat endometriosis and prevent an ectopic pregnancy. Cervical cerclage may be recommended during pregnancy in women with a history of miscarriage and/or premature birth or if an incompetent cervix is observed.