Complex Hyperplasia without Atypia... almost sounds like an exciting vacation destination, or an exotic food, No?? It is however, my new DX, and one I really could have lived without.
The RE and RON (Reproductive Oncologist) are pretty sure that this is all going to work out just fine.
They did another Saline Sono today.
The mass was gone.
The determination is that it had in fact been a piece of endometrial tissue that was much larger then they would normally see, which had just started to separate from the uterine wall when she saw it last week.
I actually made her look three times to make sure.
After the second saline injection she said "I think it is gone"
I looked her squarely in the face and said, "I don't want you to think, I want you to know."
She asked me if I wanted her to do another injection to see for myself, and of course I told her yes.
It was perfect.
here is the Short of IT:
Endometrial hyperplasia is an overgrowth or thickening of the endometrium (lining of the uterus) which may involve part or all of the endometrium. There are a variety of types of hyperplasia (simple, adenomatous) which are all benign as long as they do not show "atypia". Both hyperplasia with atypia and without atypia may regress spontaneously over months or years. However, whereas hyperplasia without atypia rarely progresses to endometrial cancer, hyperplasia with atypia is a precancerous condition that may progress to overt malignancy. Complex atypical hyperplasia progresses to endometrial carcinoma in 29% of women. Hyperplasia usually develops in the presence of continuous estrogen stimulation unopposed by progesterone. During adolescence and in the years before menopause, women may have numerous cycles without ovulation (anovulatory) during which there is continuous unopposed estrogen activity. Polycystic ovary syndrome is another condition in which women are anovulatory and have unopposed estrogen effect. Similarly, hormone replacement therapy consisting of estrogen without progesterone may lead to endometrial hyperplasia. In these situations, the addition of progesterone (by taking a progestin) or resumption of ovulation (spontaneously or with medications) can eliminate hyperplasia, especially hyperplasia without atypia.
A majority of hyperplastic lesions regress spontaneously. Hyperplasia without atypia may also resolve spontaneously or following a D&C. On the other hand, hyperplasia with atypia tends to persist even after treatment with progestin. Currently, endometrial hyperplasia is the indication for 5% of all hysterectomies performed in the U.S. In 43% of women undergoing hysterectomy because of atypical hyperplasia (diagnosed by endometrial biopsy), the removed uterus contained endometrial carcinoma. When a biopsy reveals endometrial byperplasia, it is obviously critical to evaluate the uterus before surgery with a D&C due to the high risk that a concurrent cancer is present. During hysterectomy the uterus should be inspected thoroughly and the surgeon should be ready to perform lymph node dissection if cancer is found. Hyperplasia, even after successful treatment, may recur. This is especially true if conditions of unopposed estrogen persist. It is therefore necessary to assure that unopposed estrogen condition does not continue by giving progesterone intermittently or, in younger women, birth control pills. Also, it is important to monitor such patients closely (using ultrasound, endometrial biopsies etc.) long after completion of a successful course of treatment.
Now the almost funny thing is that this usually happens to Peri/Post-menopausal women.... is that some shit?? It can be and is very prevalent in women with PCOS also. Now the bad part is that it can if left unchecked turn into cancer.
I told both docs that if I can just carry one more baby, then they can take the Ute, fill her with concrete, and use her as a doorstop for all I care. At this point she is becoming more of a liability then an asset.
There is an email sitting in the IVF coordinator's inbox that she will get first thing in the morning (I think), saying that I am totally, completely, absolutely, with-out-a-doubt, cleared to start a fresh cycle in 4 short days.