Considering #4 - complications and timing?

[insidevoice]

We have three children ranging in age from 9 years to 18 months.  The younger two are closely spaced. 

I am 33. A few months ago I was hospitalized with severe vaginal bleeding- a couple transfusions and some testing later, I have a "we're more than 90% sure this is what is going on" diagnosis of adenomyosis.  A 100% diagnosis can't be made without a biopsy of uterine tissue- usually following a hysterectomy.  There is very little research regarding the effect of adenomyosis on pregnancy and conception, as it is most often diagnosed following hysterectomy. The probability is that there is substantial effect on fertility, but it is not well researched. Additionally, the only effective treatment for the pain and bleeding which tend to become progressively worse is menopause or hysterectomy. Obviously, I feel the clock ticking here. 

My cycles are not regular. I am still nursing the youngest on demand, though he is nursing considerably less these days.

My first PP bleeding began in August, and continued through November when I was hospitalized as it increased to dangerous levels.  I was given progesterone and it did control the bleeding well, and when discontinued I had a 'normal' withdrawal bleed. That was in December, and I have not had any bleeding/menses since. 

DH and I have both come to terms with the surprising (to us!) reality that we are open to another child, and neither of us feel as though our family is complete.  I had planned on having another child (if we decided to) with another year or so of gap, but I know we can manage one sooner, though it will make for a chaotic year or so. 

I already struggle with the guilt having a larger family causes as my family is very much a one or maybe two children sort of bunch, and do not understand the decision to have more.  I am sure many assume #3 was an oops.  DH comes from a larger family. Together we have decided that a larger family is what we want- we love the dynamic. 

The question I am now faced with is, do we actively TTC a year or so sooner than we planned, or do we risk losing the chance for a fourth and wait for the timing we had thought of as ideal? 

[OTMomma]

I think you have more to consider than just the questions you asked.  Do you still want to TTC even if this condition means you are more likely to miscarry (it might)?  Will a pregnancy with this condition endanger your health in any way?  Have you looked into alternative treatments for your condition- like accupuncture?  I would consult with a doctor of chinese medicine or other alternative treatments. 

I would do my own research on the disease, and think hard about how I would handle it if I concieved and then had a really difficult pregnancy.  For me, getting pregnant right now, with a 3 year old and an 18 month old would be scary if I had a chance of needing to spend most of the pregnancy on bed rest- I don't have anyone here to pick up the slack and care of my kids if I was hospitalized. 

I don't mean to be totally negative- I just think you are in a very complicated situation.  I hope you find the right answer for you and your family.

[flightgoddess]

Definately talk over all the possible scenarios you can imagine and plan what you might do. What is the affect to your future health if you try this? Has your body been able to store enough nutrition to carry a baby or are you depleted? You could be on short or long term bed rest. The baby could be born premature; how you handle it if it was extreme? (like 28 weeks or something?) A baby born at 2lb or less and a baby born over 3 lb have very different chances and outcomes. The baby could be handicapped. In any of these situations, how would the household be handled? The kids? The finaces? Your own health/sanity?

If the best option for your health is to go ahead with the procedure, then don't forget that fostering and adoption are always an option for expanding your family too.

[insidevoice]

Thank you for the responses- it has given me great cause for consideration.  I am prepared for the possibility of miscarriage (yes, there is an increased chance- the endometrial tissue grows into the muscle of the uterus and can cause scarring.) I am prepared for some pregnancy complications, but the idea of long term bedrest wasn't one I had really given as much thought to as I probably should. 

Also, I was overwhelmed by my feeling of sadness as I read these responses and gave serious thought to not having another child.  I feel very strongly that I would like to have another child,  as does my DH, and if that isn't in the cards for us because of my health, it would be a grief I would need to process and work through. 

For me, adoption and fostering aren't options I can see myself surviving emotionally intact. I was sexually assaulted as a young woman and gave birth to a child who I chose to place for adoption.  While I am comfortable with that choice, to walk through  adoption/fostering on the other side isn't something I feel emotionally equipped to handle- even now many many years later.  Probably sounds like a crummy excuse, but I am trying to be honest with myself.