Medical terms - help me understand please

[Pepperlypue]

Hi
I had a laparoscopy and hysteroscopy with ovarian drilling and lap+dye last week, I’ve had my follow up letter and it all sounds SO negative.
I don’t understand most of it so if anyone speaks doctor could you please help me understand?

Have attached the pic of letter but taken out personal info.
(My doctor likes to focus on the fact I’m overweight - yes I am but only by around 8lbs, with a bmi of 26.4. I feel that’s worth mentioning compared with being a few stone overweight)

Thank you!

Hi @Pepperlypue I’m a doctor but have no experience in gynaecology or fertility medicine but will try and help, but obviously you’ll need to talk it through properly with the specialist. The first bit is just them saying the procedure was difficult to perform.

You have PCOS which presumedly you already knew about. They got dye through your Fallopian tubes fine meaning they are open and not blocked, but they have mentioned they are tortuous, which could mean you're less likely to get pregnant naturally than someone with normal tubes and you’re at a higher risk of an ectopic pregnancy. They have mentioned IVF for these reasons.

@Pepperlypue also they did a procedure to try to get you to ovulate and can use a medication if that hasn’t worked.

Thank you @Gardenlady543
I understand the ovarian diathermy and the medication route

I’m mostly confused by what ‘we will have a low threshold for Proceeding with assisted conception in the form of IVF’ means and what ‘some bilateral tubal tortuosity’ means, also what ‘grade 1 non occlusive tubal disease’ is.

This is the first I’ve heard from the surgeon/our doctor since the op and it would be nice if they explained it in simple terms as well as medical!

@Pepperlypue presumedly that means the Fallopian tubes are twisted. In a natural conception the sperm fertilizes the egg in the tube, the embryo then travels down the tube until day 4 when it enters the uterus, if they’re twisted, then there is less chance of it making it to the uterus and a higher chance of the embryo implanting in the tube (an ectopic). So if you did conceive naturally they would want a early US to check the location of the pregnancy.

The low threshold bit is them saying they would recommend IVF basically to increase the chance of a pregnancy and reduce the risk of an ectopic.

Thank you!
I thought the last bit about ivf was saying the opposite so that’s good to know.

@Pepperlypue a low threshold definitely means that something is advised sooner rather than later. I hope you can have a chat with the specialist soon to get a plan in place.

That's such poor form of the doctor to claim you being overweight by a few pounds is a big enough problem to make the procedure difficult! It wiffs a bit of sexism/harsh body standards for women to me. How is it even relevant for the report? It's not like the doctor is saying they couldn't complete the procedure because of your weight. They seem to have found everything they needed to. I've been on that end of things with doctors too when I was younger with a BMI of about 23. I dated a guy a number of years back who did a lot of weights in the gym. He was a big guy and muscular but he defo had a belly too and you could hear him breathing. He was probably morbidly obese but his doctor used to tell him not to worry because he was like an athlete or a rugby player 🙄

@CycleGirl20 it’s disgraceful isn’t it.
I immediately felt so so awful when I read it, I know I have some weight to lose but Jesus It’s not like I’m 4 stone + overweight with a bmi over 30.
He constantly mentions my weight in appointments too, I once mentioned that my periods seemed to be regulating after a miscarriage and he said it was because I’d lost some weight. When I said actually my periods have been massively irregular whether I’m 8 stone or 12 stone or anywhere in between, he completely ignored me!

Funnily enough he’s not a small man himself!
I find with fertility doctors/gynae docs they focus immediately on weight, almost like saying ‘come back when you’ve lost 10 lbs’ buys them more time to fuck you off.

Sorry for the rant haha! X