The Diagnosis
JUNE 2014
She paused, and her eyelids fluttered in a confusing blink as she squinted at the sonogram.
I had been looking up at the screen, but now I found myself looking at her. I noticed a fleeting moment of uncertainty through her tight smile. I recognised that expression. I had done it myself many times. It was a brief, hesitant look of unconfirmed suspicions that you try to hide so the patient won’t freak out……just yet.
It was my first transvaginal ultrasound and I openly admit that I am not used to being the vulnerable and exposed patient.
The clinic tried their best to maintain as much modesty as possible. I had on a thick white bathrobe and a towel over my legs, but the truth is there is no dignity when you’re sitting on a table with your legs spread wide while the sonographer angles the probe every which direction trying to get a clear picture of your uterus and ovaries.
Uterus and Ovaries… I remember when we commenced the first couple of weeks of our midwifery course. The topics included “Breasts”, “Uterus” and “Ovaries”. I remember shuddering slightly at the crassness of the words and thinking “What have I gotten myself into?”. Now these words are commonplace to me. A mere anatomical description with actual purpose and undermined validity.
My uterus was particularly difficult to visualise because it was “retroverted”, which means it was leaning backwards. This can occur in 20% of the population and is usually of little significance as it pops straight up as a pregnancy progresses. An “anteverted” uterus is more common and lies forward in the abdomen, like a floppy hollow little pear that leans over the bladder.
Unfortunately, it’s harder to get a clear picture with a retroverted uterus so the poking and prodding continued. “Ok, well I am going to have a quick chat with the doctor, but just stay there a minute just in case he needs to double check something.” The sweet little sonographer faked a faint smile and left the room.
“Here we go,” I thought “what now?”
While she was scanning my ovaries I noticed hundreds of darks little circles, like pockets of fluid. “That looks like a lot” I said. The sonographer didn’t say anything. “I know you can’t really say anything,” I said “But it looks like a lot to me.” She hesitated, “You are correct in saying there are many” was the best she could offer.
The 3D scan was fascinating. My ovaries looked like the inside of a pomegranate and the top of my uterus looked like an aerial photograph of a hurricane. I waited patiently and took a deep breath. I prepared myself for the worst.
The radiologist came and re-stated that my uterus was retroverted so it was hard to see, so he had to double check just to make sure etc. etc. and the prodding began again. Every which direction. When he finally got the right angle, he outlined the top of my uterus. “Are you checking for a bicornuate uterus?” I asked bravely. He nodded.
A bicornuate uterus is typically referred to as a “heart-shaped” uterus in laymen’s terms. It is a congenital anomaly (or rather birth defect) that occurs in 0.5% of the population. With little arrows he outlined the top of my uterus and informed me that no, I did not have a bicornuate uterus, but I did have a “septate” uterus. In other words, my uterus is not a hollow little pear but actually has a thick muscle or “septum” dipping deep into the uterus…the part that should be hollow.
He stood up and looked down at me sadly. “You do have polycystic ovaries,” he confirmed “and a septate uterus. I would recommend seeing a fertility specialist if you and your husband would like to start a family.”
And with a sad handshake he left me to digest that sentence.
