Recurrent miscarriages - uterine abnormality

[animavibrante]

I have experienced a few miscarriages in the past year or so, and was told that I might have a uterine abnormality.  Here's the issue - they can't determine the shape of my uterus! I was told arcuate, bicornuate and t-shaped, and that they can'tt figure it out as I have a submucosal fibroid that is blocking the view?  However, I had a MRI done on my "fibroid uterus" - so shouldn't they (doctors) be able to pick up on which type of problem I am facing here?  
Can this malformation be the contributor to my miscarriages?  Or maybe the fibroid?
And, is there any hope for me?  Treatment options?  Surgery safety?
Thanks.

[Shayne Plosker, MD]

Dear animavibrante -

It is difficult for me to answer this without seeing the studies, but my guess is that if there is nothing obvious, like a large septum or a definite fibroid in the uterine cavity, that a uterine abnormality is unlikely to be causing your miscarriages. Arcuate, bicornuate, or T-Shaped uteruses are commonly seen, and although a bit controversial in my opinion do not cause recurrent miscarraiges. MRI should be very accurate.

Are you seeing a reproductive endocrinologist/infertility subspecialist? Have you been tested for other causes of miscarriages (chromosome studies/karyotype, testing for lupus anticoagulant and cardiolipin antibodies, etc)

How many miscarriages have you had? A Danish study from the early 1990s showed that even after three miscarriages the chance that the 4th pregnancy would be normal exceeded 50%, so there is definitely still hope!

[animavibrante]

Dear Dr. Plosker:

Thank you for your reply.  I am currently seeing a reproductive endocrinologist and he's planning a hysteroscopy soon.  There is a definite submucosal fibroid within the uterine cavity, along with several polyps.  

I had a chromosome test done (from my recent miscarriage), anticoagulant and cardiolipin antibodies tests, and they came back normal.  In fact, the only test that came back abnormal is a Factor V test (positive for one copy).  Could this cause my early miscarriages?

Thanks.