Extraordinary Stromal Decidualization

Now that’s a blog post title if I’ve ever seen one! Try not to be jealous that you’ve never been quite so clever, k?
 
Ha. I’m funny.

So – that’s what I have. Not cancer (yay!) Well really extraordinary is not part of the title. That’s just what the nurse said to me when she called. I thought it was part of the title but apparently it was just a description of how badly I have Stromal Decidualization.

This isn’t so common that there is a layman term for it. It’s in fact apparently quite uncommon. Lucky me. It’s a wonder I don’t win the lottery. Maybe if I start buying tickets…

Anyway, I’m trying to come up with my own name for it. Let me know if you have any brilliant ideas.

Also, because it’s not particularly common, there isn’t a lot of easy reading to do about it when you Google it. In fact, there isn’t much of anything. And what is there is all thick medical text. The only thing the nurse said that stayed with me was “we only ever see this in people who have multiple miscarriages”. Right. Well… that would be me.

So I’ll summarize what I learned from the various medical articles I read and share some links – just in case some other woman stumbles across this blog googling for things about stromal decidualization! Don’t feel as if you have to go read all this rather boring material!

First – in case you don’t know me well or haven’t been reading my (rather inactive these days) blog for very long. I have had many, many miscarriages. I’ve never known why. I’ve just always known that I can get pregnant fairly easily but I cannot stay pregnant. I literally lost count how many miscarriages. I know that sounds morbid but at some point it was easier not to count, not to take a test, to just know I’d had one and move on.

Part 1:

Decidua is the term for the uterine lining (endometrium) during a pregnancy, which forms the maternal part of the placenta. It is formed under the influence of progesterone and forms highly-characteristic cells.

After ovulation, in mammals, the endometrial lining becomes transformed into a secretory lining in preparation of accepting the embryo. Without implantation, the secretory lining will be absorbed (estrous cycle) or shed (menstrual cycle).

With implantation the lining now termed decidua evolves further during the pregnancy.
Got all that? Once you’re pregnant the decidua thing starts (that’s the root of my issue – and the root of the word. ha! I’m funny. Really. I am. You’re supposed to be laughing now…)

Part 2:

FYI: Stroma (animal tissue), the connective, functionally supportive framework of a biological cell, tissue, or organ

The decidua has a histologically-distinct appearance, displaying large polygonal decidual cells in the stroma. These are enlarged endometrial stromal cells.

Formation of a specialized decidua is called decidualization, which is a special property of endometrium seen only in placentation.

Placentation refers to the formation, type and structure, or arrangement of placentas.

Are you following me here? Sorry. I know this is thick.

So my uterus (heretofore referred to as: Hazardous Waste or HW for short) is full of placenta cells. 14 years worth of miscarriages and build up from them.

One of the ironies of this situation? My body doesn’t do anything right and I’ve been known to say many times – at least it knows how to miscarry and I don’t have to have D&Cs. HA. Apparently I was mistaken.

So that’s the beginning of that. I get pregnant. My body starts making placenta. I miscarry but it doesn’t get rid of the placental cells.

Now…

http://molehr.oxfordjournals.org/content/16/12/886.full – there is also this related article that my friend Renee found when she was googling with me.

This one. I don’t know. It threw me for a loop. I honestly felt like I would ask Heavenly Father when I died… “So what was up with all the miscarriages, eh?” And that’s exactly when I expected to find out.

But alas – this article tells me why.

Super Fertility. For real? I also often say when talking about my infertility: I’m the most fertile infertile woman ever. It’s ridiculous how easily I get pregnant. RIDICULOUS.

The article says: In our clinical experience, however, many women with RPL, especially those who have experienced many consecutive losses, report exceptionally high pregnancy rates.

No kidding. Huh. Oh RPL = Recurrent Pregnancy Loss

Also from the article:

Superfertility in humans is currently only an anecdotal concept without obvious clinical connotations. Even in a broader biological context, superfertility is a rare phenomenon, ascribed only to certain breeds of sheep.

Seriously? This might be morbid but that made me laugh hard. OF COURSE whatever perfectly describes me would be something only proven in certain breeds of sheep. OF COURSE. Baa Baa. That’s me.

If you want to read the article, feel free. It’s long and thick but you’ll see the discussion about it’s relationship to decidualization.

Clearly, it’s nothing I can totally confirm but it so perfectly matches all the things that have happened to me and then the end result that I have – it seems fairly obvious.

So what’s the solution? When the nurse called me she said at minimum I needed a D&C to clean everything out. I told her – I don’t want that. NO NO NO. Please just take it out.

She said that I would have to discuss that with the doctor but she seriously doubted he would be opposed.

So today I was supposed to have an appointment to discuss it but between him being a baby doctor and being late for everything (babies never come when they are told!) and Drew’s work schedule – blah blah blah. It just wasn’t going to happen today. (I have to drive 100 miles to the appointment). So I asked could I discuss it with him on the phone. His nurse called me again later (same woman) and she said – are you really sure you want a hysterectomy? Yes. I’m sure. Very sure.

(Please. I have two children. And neither one of them involved my stupid malfunctioning uterus)

She said okay then. Let’s have you come in on July 11th and change it to a preop appointment.

Okie Dokie! I’m on board for that.

I’m excited to have it over. I’m  nervous as all heck for the actual doing of the thing. For the weeks after when I’m not supposed to lift over 20 lbs (Hannah weighs 22 lbs). That kind of thing. Spending the night in the hospital away from Hannah. I haven’t spent a night away from her yet. I know she’s 15  months old and she’ll be okay in the long run but I wish I wasn’t doing that to her yet.

Oh and we’re in the middle of moving. I guess that’s one way to get out of lifting heavy boxes…