Infertility after c section

Good you haven't got any cysts or fibroids. The blocked tube doesn't seem to fit with endometriosis, perhaps it just happened. Yes abdominal pain is a symptom but it seems weird that the pain was triggered after birth. Most people with endo start suffering in their teens. But let's hope your laparoscopy gives you some answers and that they can do something. Go to your GP you can get NSAIDs to reduce pain and inflammation such mefenamic acid and naproxen. Often they help. If it's abdominal it could be anything , IBS, Crohns, ulcerative coliitis , especially if it's right and middle and/or upper quadrant See if food has an impact, and maybe ask for a referral to gastrology as it may be not pelvic for the pain.
The main symptom of endometriosis is not actually period pain because endo is not a period condition - it's a whole body inflammatory condition where the endometriosis tissue even produces its own oestrogen and the pain is felt throughout the month not just when on your period. Main endo symptoms:

• Irregular or heavy periods

• Pelvic pain

• Pelvic pain on opening bowels (dyschesia) and wider gastrointestinal symptoms (diarrhoea amd constipation)

• Pelvic pain on passing urine (dysuria) and bladder symptoms sometimes

• Referred pain to the tops of the legs or back
Vomiting and nauesa.

HSG also should have detected if there is endo tissue on fallopian tubes, ovaries etc. I think it can alsobdetect adenomyosis as well. Sometimes people just unfortunately get secondary infertility with no specific cause. Hopefully they can figure it out with your surgery. I think it's unfair the IVF isn't allowed if you have one child, especially as they keep on saying we need more children.

@Lucy040288 I've seen that you've made progress eith laparoscopy congrats. I imagine you could have fibroid or ovarian cysts. Endometriosis is unlikely as during your C-section I'm sure they would have seen it - maybe check your notes from that. Also you would need to have a variety of other symptoms across the month etc not just infertility. Anyways hope you find some answers. Secondary infertility can be horrible. I'm guessing the blocked tube is having the biggest difference. Laparoscopies tend to be minimally invasive so less pain, but I think some people feel better 4-6 weeks other a little longer.

@Lucy040288 I took 2 weeks off but already had subsequent weeks booked off for Christmas; depending on your job, I’d take at least the 2 weeks, then maybe see how you feel? I’d say 3 weeks is reasonable and maybe a phased return with working from home if you have a role where that’s possible? Really listen to your body and try not to do too much too soon as it can set you back. In hindsight l overdid it at Christmas x

are there studies to back this up? I’m interested to know where this information comes from.

I just looked in up and it seems the difference is the saline sonogram is more for checking the shape and lining of the uterus. For most the HyCoSy would be fine I’d guess. https://carefertility.com/treatments/hycosy

Thanks - I did explore the spotting on my private healthcare right at the start of my fertility journey. They did an ultrasound and I saw a gynaecologist who I felt was about as useful as a chocolate tea pot and I gave up after that. Although not covered under the private healthcare, I mentioned the infertility when I went to the appointments but I wasn’t taken seriously as I was barely 6 months into trying for a baby at that point. Another instance where I was convinced something was wrong and no one would listen to me.

I am tempted to try to see if I can see another gynaecologist again though - I’ll ask for a different one - and see if I can at a minimum get a hysteroscopy paid for.

@seven201thank you that is all very helpful. I’ll write down the tests so I can discuss with my consultant when I have my follow up. The follow up is included as part of the transfer but I have decided to try someone new for further investigations, possibly even change clinic. This time I am going to stick to my guns and not be talked into another transfer without an answer or at least being satisfied I have tried everything I can. I don’t understand the approach of doctors - it makes no sense to me. Someone I spoke to described it as prescribing a cure (IVF) without a diagnosis and I feel like that is what has happened to me. If there are any fertility doctors reading this forum please enlighten me as to the rationale behind this “straight to IVF” mentality!

@Dozer yes NK still quite controversial I believe. I definitely don’t understand it all - I found it all very overwhelming at the time. For me I felt the key was having scar tissue removed and then preventative mc protocol/drugs (I had intralipids, steroids, progesterone, some meds aimed at arthritis, blood thinners). Maybe if I’d have just kept going I’d eventually have had a pregnancy that stuck naturally. I think testing and treatments are improving all the time.

Consent for an essential, unplanned C section is an interesting one @naomisno1fan !

That’s really interesting about that newer saline test@seven201 Private fertility clinics were quite varied. i had similar experiences of being told things by specialists that weren’t true in my case.

The ‘natural killer cells’ seemed the most controversial area at the time I had tests/help (many years ago now).

Having a c section does increase the chance of secondary infertility. It’s a risk to the procedure rarely shared with women before getting consent to do it.

make a complaint.

I went to a private recurrent miscarriage clinic (CRP Epsom) and had thorough testing and then when pregnant lots of drugs. I had high elevated NK cells so my immune system was attacking embryos.

@HPrior I’d had a HyCoSy (before starting ivf, a while after laparoscopy) and was just told my tubes were clear, so started ivf. But all that ivf was pointless as I had scar tissue in my uterus and didn’t know it.

i don’t know how a saline sonogram works differently but he had a clear view of my uterus and could see the scar tissue. I don’t think many places offer saline sonogram, or at least they didn’t about 3-4 years ago.

after laparoscopy I was told I had a “prominent midline septum” ridge in the uterus, which wouldn’t prevent pregnancy. But a different doctor later on said I didn’t have that, just scar tissue.

I had recurrent miscarriages after C section, much lighter periods, pain and bladder symptoms. paid for this to be investigated from the fertility aspect after a terrible experience with an NHS clinic.

I recall that hysteroscopy (not laparoscopy) was then the recommended invasive test for Asherman’s. i didn’t have it due to the cost and private specialist’s recommendation, and used progesterone in ttc and early pregnancy, and thankfully had DC2.

When DC2 arrived (2nd unplanned C section) womb / bladder were stuck together and the surgeon corrected this, after which the pain etc stopped. womb didn’t look good, v thin, scarring etc, so decided not to ttc DC3.

Also @seven201what do you mean by miscarriage testing?

Thanks for the info. I had a HyCoSy to check tubes and the uterus is checked at the same time. I think this is effectively the same as a saline sonography but I will check at my next appointment. That is strange that you had a laparoscopy but sounds like you never had anything other than ultrasound to check the inside of uterus before the saline scan? I kind of assumed laparoscopy was the last resort as the most invasive of the investigations. Was your niche very major? I have a minor one which I’ve been told is very unlikely to affect things but I wonder if it is causing problems.

@Lucy040288can I ask how did you get your laparoscopy approved on the NHS? On what basis did you refer you - was it because of the pain or the infertility or both? I haven’t even tried to get NHS treatment for any of this as I assumed it would be a no. I do also have private healthcare but fertility treatment is excluded so I’ve also felt it was unlikely they would do anything either.

Best of luck with the procedure! I’m sure you’ll be fine ☺️

I had an emergency C-section in May 2022.

I also had trepidation about how it might impact my fertility.

However everything seems fine - though I was 30 when I conceived 2nd child, so it's possible age may be factor.

Yes. Emcs and then couldn’t get pregnant for 7 years. First pregnancy ectopic and treated with drugs, second ectopic was within 6 months and had surgery, tubes fine but they removed a lot of adhesions, got pregnant and had my youngest after clomid following the second ectopic.