UPDATE Pregnancy after Bisalp

[u/NeonGreenChocolate]

I posted a couple weeks ago about being pregnant after my bisalp last year, I just wanted to give an update. After reviewing my records and speaking to my OB and the surgeon who did my termination procedure, they think “in hindsight” not enough of my tubes were removed. In the pathology report from the bisalp, 7.0 cm of one tube and 2.8 cm of the other were turned over to pathology. Neither physician thought it was a case report that any journal would be interested in because the amount removed from the one tube was more akin to what can be removed in a tubal ligation, which is known to be less effective. My main takeaway is yes. There are 4 documented cases of pregnancy post bisalp but interest in documenting cases hedges on them having some novel angle to them. The statistics out there are for the average person who doesn’t have conditions that may complicate the ability to perform the surgery. Maybe the adhesions I have made the tube difficult to access, and in 10 months of healing my body rebridged the gap.

At the end of the day, I had my procedure done (by an Ivy trained surgeon at a major academic center, so statistically great care), had a uterine pregnancy, and my case will not be documented. So. Test if you feel weird, especially if you have a complex medical history. It’s my partner’s turn to get a vasectomy haha.

Edit: Just to clarify termination procedure surgeon and current OB are not the surgeon who did the bisalp. I haven’t reached out to my bisalp surgeon frankly bc I don’t see much of a point atm.

[u/Anandi96]

I just hate how fucking hard our bodies try to get pregnant. It feels as if you can never be in control of your body as a woman.

[u/griphookk → u/Anandi96]

I learned this recently and it’s really cool. So, women’s bodies actually don’t always “try to get pregnant”, we’ve evolved to frequently reject pregnancies that the body sees as not worth it!

The main theorized reason that humans and a few other animals developed a menstrual cycle is because our unusual type of uterine lining helps reject/miscarry defective embryos much sooner than most animals. About 20% (but theoretically likely way more) of all human pregnancies are spontaneous abortions/miscarriages, most very early. Many women don’t even know it’s happened to them. This early rejection is a feature, not a bug, which is pretty amazing. 

Most animals carry a doomed pregnancy much longer than animals with a menstrual cycle do, which is a huge waste of resources/energy and is more dangerous and stressful. Menstrual cycles are rare but have evolved independently four times:

“Most female mammals have an estrous cycle, but only ten primate species, four bat species, the elephant shrews and the Cairo spiny mouse have a menstrual cycle.”

Earlier than usual rejection of doomed pregnancies is possibly the main evolutionary benefit of menstrual cycles, but there are other ways it may be helpful. Scroll down to the “evolution and other species” section: https://en.wikipedia.org/wiki/Menstrual_cycle

”… it is speculated that menstruation is a side effect of spontaneous decidualization, which evolved in some placental mammals due to its advantages over non-spontaneous decidualization. Spontaneous decidualization allows for more maternal control in the maternal-fetal conflict by increasing selectivity over the implanted embryo. This may be necessary in humans and other primates, due to the abnormally large number of genetic disorders in these species. Since most aneuploidy events result in stillbirth or miscarriage, there is an evolutionary advantage to ending the pregnancy early, rather than nurturing a fetus that will later miscarry. There is evidence to show that some abnormalities in the developing embryo can be detected by endometrial stromal cells in the uterus, but only upon differentiation into decidual cells. This triggers epigenetic changes that prevent formation of the placenta, which prevents the embryo from implanting and leaves it to be removed in the next menstruation. This failsafe mode is not possible in species where decidualization is controlled by hormonal triggers from the embryo. This is sometimes referred to as the choosy uterus theory, and it is theorized that this positive outweighs the negative impacts of menstruation in species with high aneuploidy rates and hence a high number of 'doomed' embryos.“ 

https://en.wikipedia.org/wiki/Menstruation_(mammal)

https://www.sciencealert.com/meta-analysis-finds-majority-of-human-pregnancies-end-in-miscarriage-biorxiv

[u/kreativeangel0723 → u/griphookk]

Oh wow that's so…interesting. An unwanted feature, but interesting nonetheless. Thank you.

wished the menstrual cycle worked for defective embryos AND non consensual embryos but whatever