Problems conceiving after csections

Happy Birthday! Good news that you have the eggs of a teenager

I'm not sure that you have AS either, but then again only an AS expert can really tell you that. Having pain during menstruation is not a symptom of AS as I understand it (although cyclical pain, i.e. it hurts on the days you are supposed to have your period but there is no blood, IS a sign)

This pain could be a sign of endometriosis or cysts or polyps, but I guess your HyCosy would have spotted that, was it a while ago? I know nothing about these conditions I am afraid, but if you wanted these investigated, tell your GP you have lots of pain and ask for a referral to a gynecologist. Make an appointment on Monday, you have nothing to lose! (and when they do the scan, ask how thick your endometrial lining is )
Ashermans is usually diagnosed via HSG rather than HyCosy by the way, as it is often scar tissue on the lining of the uterus that is the problem (although sometimes scar tissue blocks the fallopian tubes too)

The EPO you are taking is very good for improving EGCM as is drinking more water, cutting out caffine and booze (boo!) and drinking grapefruit juice. (lots of women on the JustMC thread swear by this and tell me the pink stuff tastes better than the yellow!) Also cough medicine that has guafenesin as the ONLY ingredient will thin all the mucas in your body including EGCM (be careful if there are other ingredients these can be counter productive) Also have you tried PreSeed or ConcievePlus? I am sure you have already looking at your earlier vitamin list

Hope you manage to enjoy the rest of your birthday xxx

Hi Dipsy,

Yes I am amazed at the speed too, and very glad I still have 6 weeks of hormone therapy and using a coil before I can TTC again though, but this doesnt feel like long compared to the 7 months I have had trying to work out what went wrong after my mc.

I am only an "expert" on the issues that I have had to deal with myself. I live in Costa Rica and have been getting (not great quality) private health care, I have seen a bunch of doctors all had different opinions on what was wrong, which made me go running to google and amazon to buy books. I therefore got accidentally clued up on lots of things I didnt actually have including:
PCOS
Molar pregnancy
pulmonary embolism
I also had (and learned about) missed mc, retained tissue, infection of uterus, Ashermans Syndrome. I have had LOTS of procedures including a CAT scan (!) I am 35 and before the mc had a healthy boy and before him had regular periods.

So back to you, if you have regular ovulation and periods I guess you can rule out PCOS (if you push your GP they can do blood tests to check, tell them you have been trying for over a year or you wont qualify) However, part of this test measures yours FSH level and this gives you a good idea of what your ovarian reserve is (how many eggs are left) This would be very useful info if you are worried about age. If you also tell your doctor you have pain you can get refferral to a gynecologist for a scan. This would show if you have a thick enough lining (try to go just before ovulation) anything below 8mm would be a worry (but you could try to build it up with medication or natural remedies) Another age related problem could be lack of EGCM which would mean your SWI timing would have to be accurate to within hours rather than days. Again, you can improve this with meds/natural remedies. Do you notice EGCM at ov time?

With regards to Ashermans I would look at this seriously if you feel that your periods have become lighter since your c sections. Do you get much less flow than before? If you are not sure, sign up to the yahoo group on the link above, talk to other ladies who have had sections and see if you feel like your story is similar to theirs. If you want to cut straight to the chase and can afford it Dr Adrain Lower can diagnose AS via 4D ultrasound, its costs £205 for the consultation and £250 for the scan. I can give you his number if you want.

xxx

I have now been diagnosed and successfully treated for Ashermans!

More info here:

www.mumsnet.com/Talk/miscarriage/1080899-Ashermans-Support-Thread-for-those-seeking-diagnosis-getting-treatment-or-TTCing-again-after-All-welcome

Thanks Dipsy. I needed that reminder about keeping close emotionally too. Its been a while now where TTC has taken centre stage and its so easy to forget that there is more to life than just getting pregnant.

lets hope we both get some good news soon.

take care xxxx

Hi,

Hope you managed to get some sleep and little one is OK.

I have joined the international support group on Yahoo for ashermans (via www.ashermans.org) - its a bit like joining the military - there are quite a lot of questionaires to get through -but WOW - there is SO much information. Doctors names, contact details, notes about which procedures they do and dont do, recommendations by patients, tons of stuff.

The only problem is that its really scary reading - I keep having to take breaks because its convincing me more and more I have AS and its all a bit terrifying!

I've just got some really useful info about treatment for AS over on this thread.

Dipsy- Yes periods and ovulation are regular, 29-30 day cycle. My tack with GP's has always been to ask for a referral because anything specialist like fertility, they are not likely to know a great deal (understandable I guess). Exaggerate the time you've been trying if needs be and say you are getting down about things which I'm sure is true. Each PCT is different I guess but here I got a referral to a fertility unit, blood tests, a HyCosy and would possibly get a few cycles of Clomid on the NHS. That would probably be the limit if you have children already. The surgery actually revealed I have an abnormal uterus (unicornuate, i.e. only half the normal size) and thus only one tube. This will obviously limit my fertilty. However, I've had 2 children without knowing about my weird uterus so I feel the main obstacle could be the adhesions caused by my c-section. Hence why I'd advise you to push for on. Also, I had a HyCosy when ttc no.2 and conceived 10 days later so I'm a fan of them!

x posts! Haribofan said it more succintly!

I was misdiagnosed with PCOS at first and now am doing repeat bloods to double check if I am premenaupasal so I have inadvertantly got clued up on these two conditions as well.

Checking FSH levels at the beginning of your cycle (usually day 2) gives a good idea of your "ovarian reserve" basically if you start running out of eggs, this hormone goes beserk producing more and more trying to stimulate the follicles into growing more eggs. As long as you dont have a high level of this, you can be assured that you are not approaching menapause.

A high level of Prolactin (the hormone produced when breastfeeding) affects your fertility and sometimes indicates a brain tumour (treatable) This would definitely be investigated further if found.

Thyroid function can also affect pregnancy rates, you would probably have other symptoms that got you to the doctors office first though, this is rarely discovered while investigating fertility issues.

The other interesting hormone is LH which should be in proportion with the FSH level. If it is higher (ratio 3:1) this is an indicator of PCOS and you would expect other symptoms which may include some or all of the following: irregular periods, cysts on ovaries, excessive hair, adult acne, weight problems, diabetes, and difficulty getting pregnant. Of course you can have high levels (an LH surge) right before ovulation, so its important your blood test is done at the right time.

The tests at the end of your cycle confirms ovulation and that your luteal phase is long enough to sustain a pregnancy should conception occur. If you have nice charts, you know this is OK already.
If you know your numbers you can compare them here

Not referring you for an HSG on the basis of having regular periods is BS really. If you DONT have a hormonal problem, surely the next step is to check if you have a structural problem, blocked tubes, scar tissue etc. This is probably more about money than medicine. If you want to persue this I would ask why they are not investigating structural issues. (you dont have to have wonky hormones to have a structural problem) Most doctors accept that the time to do investigations is after a year of TTC naturally and you have more than done this (no harm in perhaps exagerating a bit too? )

Unfortunately every Ashermans story I have read so far starts with how difficult it was to get doctors to diagnose it. I am struggling myself and I am paying private! If you want to carry on down this route, you will need to be pushy. I do hope that you dont have AS though (and me neither!) but if I were you I would want to find out sooner rather than later.

By the way, its been shown that many women get pregnant soon after an HSG, although there is no proof, doctors suspect that "flushing out the tubes" helps aid conception.

good luck too xxxx

P.S. GP's are clueless. Regular periods have absolutely nothing to do with any tubal issues.

Dipsy- I've not read the entire thread but if I were you I'd push for a HSG or a HyCosy. I've had 2 CS and been ttc no.3 for 18 months. All blood tests great etc but a HyCosy revealed my tubes and ovaries are stuck in weird positons after last CS. I've just had surgery to correct things (though my chances are slim because other things were discovered). At the very least though, a HSG would reassure you of your fertility and many people conceive after them as it kinda gives your tubes a flush through iykwim!! Good luck

Its very hard isnt it? I am also a SAHM, something which we can afford to do while living over here as the cost of living is so much less, but it would be very difficult in the UK. DH has said that if I wanted to pursue treatment over there he could look for a job there and we could relocate, which would obviously be a huge step. Its so hard to think about things like that when I dont even know for sure if I have AS! I know what you mean about claustrophobia (except mine often feels like full blown panic!) Having just lost a baby makes me want one more than ever, even though I have a wonderful DS already, I feel such an ache for another one

I have just joined the yahoo group via ashermans.org and also found a support group on facebook. Hopefully they can give me some more info on what is the most accurate, safest way to get diagnosed (and one that doesnt involve taking out a mortgage )

So will the NHS give you a Sonohysterography or HSG? If you are not eligible on grounds of fertility, could you get it for health reasons, i.e. no periods, very painful periods etc?

xxxx

Thanks Dipsy, it has been a bit of a rough year!

You make a really good point. I had already got the message from the links above that it is very important to get treated by an expert, but I hadnt thought that getting the HSG diagnostic done may cause damage.
The first gyne I saw about this wanted to do a hysteroscopy (I think she just saw ££££) but after checking out the links above I realised that there is no way I would get that done over here. I have already checked out who does what and how much it costs in London. I was hoping that the HSG would give some useful info first, because if for example I have it and it is very severe then DH and I would have to have some big discussions about whether it is worth carrying on. On the other hand, if it comes back clear we will have to decide if its worth pursuing a more expert diagnosis. Here is a study (2005) which shows that an HSG only spotted AS in only 60% of cases! Well I still have some time to decide what exactly to do next, as I have to take the pill for 5 days more, then do some bloods 8 days after that. (I would bet money the bloods come back normal, its just a repeat of what was done 2 months ago and they were fine)

So it looks like you are even further down the investigative road than me, it must be very frustrating after all this time not to have answers. Any idea what your next move is?

take care xxx