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Trachelectomy


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#1 HOV

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Posted 02 May 2008 - 06:36 AM

Hi Everyone, I am new to this forum but certainly not new to the fertility ratrace. I have been doing fertility treatments for almost three years. In 2005 I was diagnosed with Cervical Cancer and had a surgery called Trachelectomy at Sunnybrook Regional Cancer Centre. I had my entire cervix and my pelvic lymph nodes removed as a result of Stage 1 cancer. I am happy to report I am over 2 years cancer free but the absence of a cervix adds a whole new problem (on top of my already elevated FSH of 11). I CAN get pregnany and CAN carry a child but I have an elevated risk of Miscarriage. Since we started the fertility journey I have done 6 cycles of IUI (with a mixture of Clomid and Puregon) and got pregnant once. I miscarried at 8 weeks. Took some time off to get sane again and then in Nov'07 we did our first cycle of IVF. I responded well to the drugs and produced 22 follicles on my right side, 19 of which were mature. Sadly only 6 fertilized through ICSI (I am guessing my egg quality sucks).
Because I cannot carry twins (my womb isn't strong enough after the Trachelectomy) only two embryos were transfered in hopes one of them would implant. The other embryos died (which we were told on Christmas Eve). Although I was sure I was pregnant (sore breasts and all) the Beta test revealed I wasn't PG. Sad day. It's now months later and we are set to start all over again. I would LOVE to chat with other women who have Trachelectomys as I feel VERY alone in this struggle.

#2 yanie

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Posted 02 May 2008 - 06:56 AM

welcome. and good luck on your journey.
age: i'm 30 husband is 33
married: for 6 years togther for 13
ttc:5 years
clinic :mcgill reproductive center in montreal
told i have severe PCOS
husband is great
JUNE 07 clomid 50mg did not respond to meds
JULY 07 clomid 100mg did not respond to meds
AUG 07 doing IVM for a study
SEPT 1, 07. 33 eggs collected, 27 matured and frozen
SEPT 12, 07. 3 were put in. a 4cell and two 3cell
SEPT 14, 07 BFN from IVM
DEC 7, 2007 D&C went well
MARCH 10, 08 IVM, E/R 12 mature eggs 30 inmature eggs total 42 eggs
MARCH 13, 08 E/T tranfered 3, Two 8 cell, and One 7 cell embryo's.
MARCH 26, 08 beta .08 BFN
SEPT 9 FET PUT IN 4, a 8cell,a 7cell, two 6cell
SEPT 23 beta 8.3 BFN
have 3 frozen
total of 75 eggs collected in 2 E/R
total of 10 embryos put in in 3 E/T.

moving to IVF
giving to science
3 embryo's
and 23 oocytes

starting fresh with IVF!

April 9, 2011 took a HPT and got a BFP!!!
April 13, 2011 found out that i'm 8 weeks and 2 days pg!
natural pregnancy
It's a Boy!!!!!



I am too postive
to be doubtful
too optimistic
to be fearful
and to determined
to be
defeated




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#3 mouse

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Posted 02 May 2008 - 07:32 AM

Cyberhugs to you, HOV. I don't share your experience and to be honest I'm not sure I can even begin to imagine what your path has been like. Your strength is a great example and I will remind myself of you and your will to go for the brass ring the next time I have a 'poor me' moment. Hoping you find the support you need and have great success in your next cycle.

me 49, he 50 30 years together!
History: ectopic; late miscarriage
Many child 'free' years
Success on 2nd IVF (Halleujah! and happy 44th birthday to me!)
SHE'S HERE! SHE'S HERE!Born 05/11/2010 8:25pm. 5 lbs 13 ozs of absolute sunshine!
Tea parties, mud pies, and glitter!
Exploring options for IVF#3 (OE).
Test results appear promising and we are greenlighted.
4 mature eggs retrieved 04/06/14. All fertilized normally; scheduled for transfer on 04/09/14.
All 4 on board; beta set for 04/17/14. Second beta scheduled for 04/21/14. 3rd beta set for 04/23/14. Sono to see what might be going on set for 04/24.
Waiting game is over; another ectopic.


#4 HOV

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Posted 02 May 2008 - 07:47 AM

Cyberhugs to you, HOV. I don't share your experience and to be honest I'm not sure I can even begin to imagine what your path has been like. Your strength is a great example and I will remind myself of you and your will to go for the brass ring the next time I have a 'poor me' moment. Hoping you find the support you need and have great success in your next cycle.


Thanks so much Mouse, but my struggle is no more than yours. All of us have had a hope dashed and need to stay strong to keep putting one foot in front of the other. I have lots of "poor me" moments, believe me- Just ask my husband!! LOL! I oscillate between giving up and pushing forward almost on a daily basis. Today is a "pushing forward" day....I hope you are having one of those too!!

#5 jgeddes

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Posted 02 May 2008 - 07:56 AM

Hi HOV,
I, as well, cannot relate to what you've been through. I admire your strength! I hope you find lots of love and support from this site as so many of us have! best of luck to you!

Julie
me: 27 DH: 35
diagnosis: extreme male factor
IVF/ICSI: December 2007 *BFP*
beautiful baby girl born!

Lauren Claire born August 17, 2008! 6 lbs 13 oz!! we love everything about her!!
next step: we're ready to try again!
apointment with RE April 1, 2009 - appointment cancelled :( We were thinking about buying a bigger house, but the plans have changed....reality check tells us that we can't afford IF and a new house...:( so the house can wait!
FET planned for July/09......we're hoping to be blessed again!
June 30 - start syneral
July 13 - suppression check - good!
July 22 - lining check "more than perfect"
July 27 - FET! 1 six cell grade A, 1 8 cell grade B embroy transferred (one frosty remaining)
August 4 - HPT faint positive (x3)
August 5&6 - HPT BFP!!!! yay!!!!

Beta - August 10t = 796!!!!!
August 17th - started spotting and cramping
August 20 - bleeding bright red - beta 18996
August 22 - beta 27696
August 24 - early ultrasound shows one healthy little bean with a heartbeat!! measuring right on track at 6w3d!thank goodness!! fingerscrossed the bleeding stops soon!
September 3 - ultrasound looks good! one healthy bean! EDD April 16, 2010
October 4 - ++ heavy bleeding --> ER - ultrasound shows healthy happy baby, no explanation for bleeding. Off work for 2 weeks.
October 19 - ultrasound booked, if all is well I can go back to work! only back to work for 3 shifts and had another bleed :(
November 3rd - yet another ultrasound to try and figuring out all the bleeding (another big bleed today)...found "answers" but have to wait for appointment on November 5th to discuss results. ** it's a BOY!!! **
diagnosed with "chronic placental abruptions"...praying that our little boy hangs on!!

April 11, 2010 - Liam Reed born! 8lbs2oz, 21 inches long...we are in LOVE!!! thanking our lucky stars that this pregnancy is over and we have a healthy baby boy in our arms!!

#6 lela_ro

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Posted 01 September 2008 - 07:31 AM

Hello! I am a new member. Last year I have been diagnosticated with cervical cancer stage 1a2. I have had a radical trachelectomy with limphadenectomy 5 months ago. Now, I am feeling good, but very tired. Maybe because of the work, maybe because I haven't recovered totally yet.
My doctor told me that I am ok now and that I can become pregnant after 1 year for the operation. I am scared of being pregnant, cause I know how risk it will be to miscarriage the baby. But that's life! Who doesn't risk, doesn't win. I want to chat about women who have had trachelectomy about everything that could happened in their life after. About diet, intimate life, their psihic, phisical life, everything!

#7 gwen_t

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Posted 04 December 2008 - 03:23 AM

I had a radical trachelectomy in September, also with removal of the lymph nodes, for a stage 1B cervical cancer. I wasn't told that i had to wait before getting pregnant (although I'm still waiting for my normal menstrual cycles to return) and want to start trying as soon as I can, as I'm 35 now. My first (and only) child was a beautiful little girl, born in July after a perfectly normal pregnancy who died from a heart defect. My doctor has prescribed an ordinary contraceptive pill to try and induce menstruation, and then Clomid. I've also been told that it can be difficult to conceive after a trachelectomy, and because of the elevated miscarriage risk I don't want to lose any time.

I haven't had any other issues since my trachelectomy - I have a large "dead" area on my abdomen, which also seems to lack muscle tone, but that could still be an after-effect of my pregnancy. I was warned that I might have bladder problems, but haven't, and that the removal of the lymph nodes could cause swelling in the legs, but that hasn't been a problem either.

#8 HOV

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Posted 04 December 2008 - 07:32 AM

Hi Gwen- I am happy to report that I am pregnant. It's been 3 years since my Trachelectomy and as you can see from my Signature, it has been a long road. Having a Trachelectomy does add a new dimension to trying to conceive. It also adds risk to a pregnancy. I am being referred to a High Risk OB who will follow me throughout my pregnancy. I am still only 7 weeks so I am literally taking one day at a time. I had my first Ultrasound yesterday and heard the heartbeat!!

I am living proof that you can conceive after a Trachelectomy (sadly my first pregnancy ended in Miscarriage). Hang in there and be patient! It may not happen overnight. Also be sure you are working with an RE who knows about the special issues with Trachelectomy patients. Embryos transfers can be difficult as we only have a small OS in which they must insert the catheter. It can be a very delicate procedure.

I wish you the best of luck in your journey. If you ever have any questions, fell free to PM me.
HOV

#9 mouse

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Posted 04 December 2008 - 08:11 AM

Sorry to butt in, but HOV I just wanted to say YAY! 7 weeks! Congratulations! Fingers crossed the remaining weeks pass smoothly!

me 49, he 50 30 years together!
History: ectopic; late miscarriage
Many child 'free' years
Success on 2nd IVF (Halleujah! and happy 44th birthday to me!)
SHE'S HERE! SHE'S HERE!Born 05/11/2010 8:25pm. 5 lbs 13 ozs of absolute sunshine!
Tea parties, mud pies, and glitter!
Exploring options for IVF#3 (OE).
Test results appear promising and we are greenlighted.
4 mature eggs retrieved 04/06/14. All fertilized normally; scheduled for transfer on 04/09/14.
All 4 on board; beta set for 04/17/14. Second beta scheduled for 04/21/14. 3rd beta set for 04/23/14. Sono to see what might be going on set for 04/24.
Waiting game is over; another ectopic.


#10 gwen_t

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Posted 05 December 2008 - 01:38 AM

HOV, congratulations. All my prayers are with you for a happy and successful pregnancy. Take it easy and best of luck.

#11 gwen_t

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Posted 09 December 2008 - 02:20 AM

Well, I saw the FS yesterday - lovely man, very reassuring. It seems that my worries about not menstruating for 3 months since my trachelectomy were misplaced - my cycles have been normal, but the cervical opening is completely closed with scar tissue, so the blood is pooling in the uterus. He tried to insert a catheter, but couldn't. I'm seeing the surgeon for my 3-monthly "cancer check" tomorrow, he will have to do something, dilate the opening I suppose. I'm not sure what's involved, but I'm assuming it's a relatively minor procedure.

On the plus side, all my bloods, hormones etc were normal, so it seems there are no fertility problems other than those directly related to the trachelectomy. The absence of cervical tissue may pose a problem as there may not be enough (or any) cervical mucous, which means we may need a help with insemination. The FS wasn't sure about the stitch in my cervix - which he described as an "external stitch" and asked the surgeon for a report on it - if there's any doubt then he would recommend the insertion of an "internal" stitch as well, which will apparently be a surgical procedure and will have to be done before I get pregnant.

A little vent now about my usual gynaecologist - perhaps I'm being a high maintenance patient, but I feel that after all that's happened this year I deserve a little extra attention from my doctors. When I phoned my gynae to ask about the absence of periods, he prescribed (by fax) a contraceptive pill to be taken for 10 days and then stopped to induce a period. He didn't examine me. Now it seems that there is nothing wrong with my actual cycles, just that the opening is closed so that nothing can escape. This is the same gynae who -

1) did a pap smear last year which was apparently normal - I know that it is theoretically possible for cancer to progress that fast, but my understanding is that it usually develops over a lonber period
2) failed to notice my baby daughter's heart defect, even though he 5 or 6 scans during my pregnancy - again, I know that these problems can't always be picked up during pregnancy, but that's 2 question marks now.
3) performed a colposcopy on me after my abnormal pap smear this year which resulted in me haemorrhaging so seriously that I had to be admitted to hospital and put on blood clotting medication (on top of it all, it was "inconclusive" and I had to have another one done a week later, by a different specialist, who managed to cauterise it properly so that there was no excessive bleeding).

It just seems like one too many things have gone wrong that could possibly have been avoided or mitigated if he had taken a little more care. So I'm shopping for a new gynae.

#12 HOV

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Posted 09 December 2008 - 08:15 AM

Hi Gwen- I can see why you would want to find another Doc. It's much better to be using someone who is familiar with your situation and is sensitive to it. My RE is very good with Trachelectomy patients. She has been very good at finding my OS with thin catheters and ultrasound guidance. It is a very delicate procedure because the slightest bit of blood can prevent a successful transfer (whether through IUI or IVF).

In terms of your "Stitch": If you do not already have one, a Cerclage is usually put in at about 12 weeks of pregnancy. When your surgeon did your Trachelectomy he may have already placed a Cerclage in anticipation of impending pregnancy.

Your doc will likely want you to try to conceive "naturally" for a year (depending on your age) before proceeding with artificial means. I tried for a year post surgery- no results. Then I was referred to my current RE who started with non-invasive procedures like IUIs (with and without medication). Then I moved up to injectables and did get pregnant once with IUI. It ended in miscarriage pretty early. Then we moved on to IVF and did that twice (BFN both times). We were really getting close to giving up completely when we did a FET and I got pregnant!!

My advice would be to take it ONE DAY AT A TIME. Remember that you have special circumstances so things that work for women with cervixes, may not work for you. A good Doc will recognize your personal circumstances and customize a plan for your needs.

p.s. If the doc could not insert a catheter it means he was having a difficult time locating your OS. You have to have an OS or you would not be able to menstrate and I assume infection could set in. You also have to have an OS in order for sperm to "get up there" naturally.

Anyway- that's just my two-cents worth after 3 years of being on this road.....

#13 gwen_t

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Posted 09 December 2008 - 09:00 AM

I have a Shirodkar stitch which was inserted during the surgery. I think that the doc wants to be sure (after the surgeon examines me tomorrow) that this will be sufficient, otherwise insert an additional abdominal stitch (which will require MOOOOORE surgery).

I'm 35 now, so we don't want to spend a year trying naturally. Clearly the opening (I'm trying to think exactly what "OS" stands for, although I can guess) needs to be dilated, for the reasons you state. After that, doc wants to monitor one full cycle to make sure that ovulation etc is proceeding normally. If so, next will be a test to see if there is enough cervical mucus for fertilisation to occur "naturally", otherwise we'll try IUI. That's really as far as we've thought ahead.

One day at a time is good advice. But it's so hard. I have a fully furnished nursery, complete with cot, teddy bears, changing mats, clothes, cream, towels, nappies, pram, car seat, hearbeat noises in the CD player, all ready for the baby we thought we were bringing home in July, and every time I walk past it I want to be pregnant right NOW. I can't bear to redecorate the room yet...

#14 HOV

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Posted 09 December 2008 - 09:29 AM

It really broke my heart to hear about your nursery. It must be SO hard for you to see that everyday. Try to hang onto hope that things will work out for you. I know it's hard. I have lost faith many times when you get more and more disappointing news, but we have hung in there together (DH is a Godsend) and now we take each day as it is presented to us....we really have no other choice.

BTW: An Os is just a medical word meaning "opening or mouth"- not an acronym. Since we no longer have a cervix we need an os in order to menstrate properly. I hope you get that situation cleared up soon...I'm sure you would like your cycles back to normal sooner than later!

Good luck
:)

#15 gwen_t

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Posted 11 December 2008 - 01:56 AM

Yesterday I had my 3 month (post-surgery) examination. No visible signs of recurrence, although I'm still waiting for the lab tests. The menstruation problem turned out to be quite simple - just a little membrane that had grown over, which was perforated so that the blood could flow out - it felt like a tap being opened! The surgeon (this is a different one to the surgeon who actually performed the procedure, who is based in another city), was also iffy about the stitch, although he would wait and see how a pregnancy progresses before deciding on an abdominal stitch - don't really fancy the idea of abdominal surgery WHILE I'm pregnant, but I suppose we'll cross that bridge when we come to it.

At any rate - one obstacle out the way at least (two if one counts being apparently cancer-free) :)

#16 chouette

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Posted 12 November 2009 - 08:21 PM

Hi All,

Not sure if anyone is still on this thread but I had a trachelectomy 5 yrs ago and I'm now TTC. Had an IVF cycle last month but it failed. I was just wondering if anyone is out there who can fill me in on their experiences with IVF and / or pregnancy. I am seeing Dr. Glass at Create Clinic. Has anyone had 2 embryos transferred? Dr. Glass has informed me they usually just transfer one embryo because of our surgery and lack of cervix. But my ovarian reserve is low and I'm wondering if I should ask to have 2 transferred next time. Just wondering what other people's experiences have been post-trachelectomy. Any input would be much appreciated!!! Much thanks!
April 2004 - Trachelectomy surgery (removal of cervix) due to cancer
May 2004 Lymph nodes clean - no further treatment required
May 2009 - scar tissue and stenosis identified due to surgery
May 2009 - low AMH / ovarian reserve identified
June 2009 - Surgery to remove damaged fallopian tubes (bilateral) and endometrioma (resulting from stenosis)
IVF #1 Antagonist protocol - BFN
IVF #2 Micro-dose Flare - BFN
April 2010 - IVF #3 Minimal Stimulation - single embryo transfer - first BFP ever!
Beta #1 - 25 (yikes)
Beta #2 - 76
Beta #3 - 352
Beta #4 - 1653
May 11 2010 ultrasound shows one little bean with h/b of 132!

#17 Rosa

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Posted 12 November 2009 - 09:16 PM

I can't speak about the experience with trachelectomy but I did see Dr. Glass at Create for my IVF treatments. She is a good doctor. I believe they recommend transferring one in your case as you likely wouldn't be able to carry twins. The question you need to ask yourself is, would you be comfortable doing a selective reduction (if necessary) if you got pregnant with twins?

The decision on how many to transfer is such a tough call because your age, previous IVF failures etc. all play into how many to transfer. I transferred more than 1 as I had a number of IVF failures and I was over 40.

I would trust Dr. Glass advice.....she is a great doctor.


Me 45, DH 41
TTC 3 years
Uterine polyps, high prolactin levels and tested positive for anti-cardio lipin
5 failed IUI's
IVF #1 July 2007, 32 eggs retrieved (many immature), 12 fertilzed, 9 made it to day 3, transferred 3 embbies, BFN
FET #1 - 3 embryos Oct 07, beta Nov 2nd, another BFN
IVF #2 - Nov 2007, on Lupron and birth control pill, 11 days of stims 225 Gonal F plus 75 Repronex and 150 Gonal F at night, retrieved 18 eggs Dec 11th, 8 fertilized through ICSI and 4 naturally
Transfer - 3, 8 cell embryos Dec 14th, BETA Dec 28th, BFN
7 frozen
FET #2 - June 5/08, BFN
hysteroscopy and polypectomy on Sept 25/08, removed 1 polyp
FET #3 - used up my last 4 frosties Oct 27/08
Beta Nov 9/08 125 BFP 13dp3dt
Beta Nov 11/08 315 15dp3dt
Beta Nov 15/08 over 2000 19dp3dt
Beta Nov 18/08 7365 22dp3dt
U/S date Nov 29/08, a singleton, heart beat 131 beats per minute
U/S date Dec 7/08, heart beat 160 beats per minute, growth good 8 w 2 days
U/S date Dec 13/08, heart beat 157 beats per minute, growth good at 9 w 1 day, baby moving around
U/S date Dec 27/08, heart beat 165 beats per minute, growth good at 11 weeks 1 day, baby moving around, now has arms and legs and was kicking
nuchal test US Jan 2/08 TEXTBOOK NORMAL Thank you God!
IPS pregnancy test results NORMAL, risk is 1/800 of Down's Syndrome and 1/1,100 for spina bifida
anatomical u/s NORMAL, it's a girl!
Due date July 18, 2009 in the home stretch

Sophia Anne born July 22, 2009 at 12:41 AM via emergency C-Section.

Fell down the stairs Aug 4, 2010, fractured C7, T1, T3 and 4 ribs (neck and upper spine). Still healing and hoping bones fuse on their own.

#18 HOV

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Posted 13 November 2009 - 09:58 PM

Hi Chouette- I am happy to report that my little one is 4 months old and I had a pretty good pregnancy- despite several hospital stays. Actually getting pregnant was a journey for sure- but it was all well worth it. Dr. Glass was also my doctor and she was great. I was referred to a High-Risk OB at Women's College after I reached 10 weeks. I had very frequent Ultrasounds and was off work as of week 26. I had to give up exercise and basically just loaf around for my pregnancy.
If you'd like to know more about my journey PM me and we can chat.
HOV