Why This Site Exists
One woman’s four-year journey — and her determination to make sure yours is shorter.
Four years.
That’s how long it took Karen Floyd to get from something is wrong to we finally know what it is.
After the birth of her first child via cesarean section in 2018, Karen began noticing something wasn’t right. Prolonged spotting. Unexplained infertility. Cycles that never quite returned to normal. She saw doctors. She asked questions. She was told it was normal, that it would resolve, that she just needed to be patient.
She wasn’t getting answers. She was getting dismissed.
“I kept being told everything looked fine. But nothing felt fine.”
— Karen FloydThe Diagnosis That Changed Everything
More than a year into searching, Karen finally received a diagnosis: isthmocele — a defect in the scar left by her cesarean section. A small pouch in the uterine wall where fluid pooled, scarring accumulated, and her body quietly struggled to do what it so desperately wanted to do.
Finally, a name. Finally, a direction.
The diagnosis came with measurements that told a difficult story: a deep niche extending into the cervix, minimal residual myometrial thickness, fluid present in both the niche and the uterine cavity. She’d also experienced two miscarriages by this point.
The word isthmocele was brand new to her. She went looking for information and found scattered forum posts, outdated medical papers, and a Facebook support group filled with women who had heard the same thing she had: “I’ve never seen this before.”
The First Repair — And What Came After
In November 2023, Karen underwent her first laparoscopic repair. The surgery revealed what the imaging had only hinted at: endometriosis, adhesions, cysts, polyps, and inflammation. Her body had been quietly fighting for years.
The repair was completed. She waited. She hoped.
But the niche persisted. The first repair hadn’t held. She would need to do it all again.
Flying Across the Country for a Second Chance
Karen and her husband Joseph did what anyone would do when the stakes are high enough: they found the best person in the world for the job.
Dr. Gavin Puthoff in St. Louis, Missouri — a NaProTechnology surgeon who had performed over 300 isthmocele repairs with a documented 100% success rate. They flew out to meet with him. They put their hope in someone who had done this before, who understood the anatomy, who knew what good looked like after repair.
The second surgery was in 2024. This time, it worked.
Gracie Rose
Four months ago, Gracie Rose Floyd was born. She is Karen and Joseph’s third child — and living proof that the right diagnosis, the right care, and the right surgeon can change everything. She is the reason this website exists.
The Mission
The Niche Project is Karen’s answer to the question she kept asking during those four years: Why is this so hard to find out? Why is no one collecting this data? Why do women have to fight this hard just to get a name for what’s wrong?
- A registry — real data from real women to help researchers and doctors
- A resource — clear, accurate, compassionate information
- A community — so no one has to figure this out alone
Every woman who submits her story makes the registry stronger. Every story shared helps someone else feel less lost.
The Niche Project is a patient-led initiative, not a medical organization. We don’t provide medical advice. We collect patient-reported data, share educational resources, and help connect women to the information and community they need.
Your story matters too.
Add your experience to the registry and help the next woman get answers faster than you did.
Share Your Story Browse the Registry