Back in December, we learned something new about my uterus that might explain the fertility struggles and miscarriages we’ve been dealing with since 2022.
During a saline sonohysterogram (SIS), imaging suggested that I might have a uterine septum and possibly a T-shaped uterus. Neither of those are great for pregnancy outcomes, and they can increase the risk of miscarriage.
After reviewing the images, Dr. Charles Miller, a renowned surgeon, recommended surgery to try to reshape the uterine cavity. The plan was straightforward: wait for my February period, then schedule the procedure shortly afterward.
But February arrived… and my period never did.
Because I was pregnant.
At the time, we had no idea that this pregnancy would turn into another loss, or that it would eventually help confirm a uterine septum diagnosis after an ultrasound showed a yolk sac but no fetal pole.
A Spontaneous Pregnancy
After years of fertility treatment and complications from Asherman’s, a spontaneous pregnancy felt almost surreal.
We cautiously started monitoring things with bloodwork. The doctors ordered three HCG tests, and all three showed a reassuring pattern. The numbers were doubling exactly the way they should.
For a brief moment, it felt like maybe this one might work.
At six weeks, the first ultrasound showed some early development – a gestational sac and a yolk sac. It wasn’t definitive yet, but it was progress.
We held our breath and scheduled the follow-up scan.
When Progress Stops
At the seven-week ultrasound, unfortunately nothing had changed.
There was still a yolk sac, but no fetal pole and no further development.
Another early miscarriage.
If you’re reading this because you had an ultrasound that showed a yolk sac but no fetal pole around six or seven weeks, you’re not alone. We spent the entire week between ultrasounds trying to figure out what that meant and whether there was still hope.
Sometimes it really can just be early, especially if ovulation happened later than expected. Early embryos grow incredibly quickly, and a difference of just a few days can change what appears on an ultrasound.
But when a follow-up ultrasound about a week later still shows no embryo, doctors can usually confirm that the pregnancy stopped developing.
After everything we’ve already been through, it’s hard to describe how heavy that moment felt.
A Four-Hour Drive for Answers
After we told him the bad news, Dr. Miller asked us to come down to his office in Naperville, IL.
So we drove four hours south so he could perform a hysteroscopy with a D&C.
A hysteroscopy allows the doctor to actually look inside the uterus with a camera, which is the most accurate way to diagnose structural problems.
While he was in there, he confirmed something important.
I do have a uterine septum.
But the suspected T-shaped uterus was actually a misdiagnosis.
That was a huge clarification. A septum can absolutely increase miscarriage risk because embryos that implant on the septum may not receive adequate blood supply.
Dr. Miller said it’s very possible that the septum has been the cause of some, if not all of my miscarriages.
In other words, this might finally explain what’s been happening.
The Test We Couldn’t Do
Dr. Miller recommended doing genetic testing on the pregnancy tissue that was removed during the procedure.
That test can determine whether a miscarriage happened because of a chromosomal abnormality in the embryo, or because of something structural – like the uterine septum.
Unfortunately, our insurance wouldn’t cover it.
The cost would have been $3,000 upfront, on top of the $3,500 we had already been required to pay that day before surgery.
So we had to decline the test.
Insurance, once again, proved to be a pretty spectacular scam.
Uterine Septums and Miscarriage
A uterine septum is one of the most common structural uterine abnormalities. It is a congenital condition, meaning it develops before birth while the mother herself is still in her own mother’s womb. During normal fetal development, the uterus forms from two structures that fuse together and the dividing wall between them dissolves. When that wall does not fully dissolve, a uterine septum remains.
The result is a band of tissue that divides part of the uterine cavity.
The problem is that this tissue often has poor blood supply. If an embryo implants on the septum instead of the healthy uterine wall, it may not receive enough oxygen and nutrients to continue developing.
That’s why uterine septums are strongly associated with recurrent miscarriage.
The good news is that septums are often treatable with hysteroscopic surgery that removes the extra tissue and restores a normal uterine cavity.
For many patients, repairing the septum significantly improves pregnancy outcomes.
If You’re Going Through Something Similar
If you landed on this post because you’re going through something similar, I’m really sorry. Miscarriage can feel incredibly isolating, especially when the answers aren’t clear and every test seems to raise new questions instead of resolving them.
One thing we’ve learned through this process is how many people quietly go through fertility struggles and pregnancy loss without ever talking about it publicly.
If that’s you, please know you’re not alone, even if it feels that way right now.
Sometimes the only thing that helps is finding someone else who has walked through the same confusing maze of ultrasounds, test results, and waiting rooms and come out the other side with a little more information than they had before.
If sharing our experience helps even one person feel a little less alone while they’re navigating their own version of this, then at least something good came out of writing it down.
Yolk Sac but No Fetal Pole – What It Can Mean
After our second ultrasound showed a yolk sac but no fetal pole, we spent a lot of time trying to understand what that meant. It turns out this is a situation that a lot of people encounter during early pregnancy.
When an ultrasound around six weeks shows a gestational sac and yolk sac but no fetal pole, it can sometimes just mean the pregnancy is earlier than expected. Ovulation can happen later than predicted, and early embryos grow incredibly quickly from day to day.
That’s why doctors typically schedule a repeat ultrasound about a week later before making any diagnosis.
If the follow-up ultrasound still shows no embryo after a week of waiting, doctors can usually confirm that the pregnancy stopped developing. This type of loss is often called an anembryonic pregnancy or a blighted ovum.
In our case, the follow-up scan showed no further development, which is why the miscarriage was confirmed.
Early pregnancy loss is unfortunately very common. Many miscarriages happen because of chromosomal abnormalities in the embryo, but structural issues like a uterine septum can also increase the risk.
Every situation is different, which is why doctors often recommend additional testing or procedures when someone experiences recurrent pregnancy loss.
What Comes Next
Our doctor’s recommendation is to repair the septum.
Once my uterus has healed from this procedure and from the miscarriage, we’ll move forward with surgery to remove the septum and reshape the cavity.
After that… we’re honestly not entirely sure.
We don’t know whether we’ll try naturally again, go back to fertility treatment, or take some time to breathe before making another plan.
What we do know is that for the first time in a long time, we may finally understand why this keeps happening.
And even though this loss hurts as much as the others, having a possible explanation – and a possible fix – gives us something we haven’t had in a while.
A path forward.
If there’s anything this whole journey has taught us, it’s that fertility is rarely a straight line. Every test seems to uncover a new clue, every setback rewrites the plan, and every doctor has another piece of the puzzle. This time the clue just happened to be hiding inside my uterus the whole time. We don’t know exactly what the next chapter looks like yet, but we finally have something concrete to address. For now, that’s enough to keep moving forward.
