Infertility after c section

I was terrified too, but there’s really nothing to be afraid of. The pain afterwards was so minimal compared to the c-sections! The gas pains are the real demon….it felt like I had a broken collarbone and bruised ribs for 4-ish days afterwards. But you literally just have to burp/fart it out over time….🫣 I don’t know why they can’t just vacuum it out of you at the end of the surgery!

I hope yours goes smoothly and they are able to find something in there that is easy to fix and you will go on to have a happy, healthy pregnancy 🤞 🤞🤞

Sorry if someone has already suggested this but have you had a saline sonogram, (it is different to an ultrasound)? I had a c-section, then a brief pregnancy, a couple of years of mild fertility treatment, a laparoscopy (and was incorrectly diagnosed with a ridge in my uterus that shouldn’t be a problem), years and many rounds of ivf, then someone on the infertility forum suggested I go for a saline sonogram. Turns out I had scar tissue. I then had surgery mainly to remove the scar tissue that was “acting like a natural coil” and he also neatened up by c-section niche as fluid pooled there and removed a cyst. I then very quickly had another two brief pregnancies. Next bit I’ll shorten - I went elsewhere for miscarriage testing and meds and was put on all the drugs. I now have my amazing daughter. There’s a 7.5 year gap, not the 2yr one I wanted.

I saw Adrian Lower just off Harley street for both the scan and the surgery. I’d never heard of that scan before, but definitely worth doing I think.

I had 2 c-sections and found myself mysteriously unable to conceive a third, despite having no trouble with the first two.

Spent 1.5 years trying before getting a private laparoscopy because I suspected I had some scar tissue adhesions from my earlier pregnancies and c-sections. I also had / have endometriosis but I am pretty sure that I have always had it, so I wasn’t too concerned about that being a factor.

Turns out I had a lot of very sticky adhesions - my bladder was stuck to my abdominal wall, my right ovary was stuck to the side of my abdomen (that’s what always ached and hurt when I sneezed!) and my left fallopian tube also had some blockage due to scar tissue and that was resolved through the surgery. The endometriosis was also cleared out.

7 weeks after the surgery - I’m pregnant! I only regret not having the laparoscopy sooner. I feel like I knew there was a physical issue in there somewhere, and like you I felt like I had a lot of “almost pregnancies” in that 1.5 years. Something felt wrong. Trust your instincts and go for a laparoscopy just so you know what things look like in there. Fertility chances increase in the 6 months after a laparoscopy anyway, regardless of what they find, for some strange reason.

Go private if you can afford it, it’s worth the speed and convenience. And you can ask for a video of the procedure!

Thank you ❤️ dr Brosens in Coventry has an implantation clinic - looks like maybe an he from derby so may be worth investigating x

@Lucy040288I had a call with the company that run the Receptive DX test this afternoon. Obviously it was someone selling the product so something to bear in mind but it sounded like it might be worthwhile. It detects BCL6 levels which, if elevated, indicate inflammation which can be linked to endometriosis. He did say because I had a blocked tube he would caution against assuming a positive result was endo because blocked tubes can also cause inflammation. However, I still think the test could be helpful if it shows inflammation and I can then explore the cause of that. You can also use the test to look for a marker called CD138 which indicates a bacterial infection or endometritis. He said the test is widely used in the US but they have had difficulty selling it to clinics in the U.K. market. There are a few places that do it in London including the Lister. He said they send a kit to you which you take to your clinic (I assume to do the endometrial biopsy) and then the sample is sent away to them so I don’t know if specific clinics actually have to offer the test - you just need a doctor to take the biopsy. Though I’d mention as the call I had was free and he spoke to me for about 30 minutes.

Hi Lucy, I am so sorry to hear about your miscarriage. I can only imagine how devastating that must have been getting your hopes up and then experiencing loss after 17 months. One thing it does show is that you have a functional fallopian tube so it is not blocked tubes causing the issue and suggests IVF as a quick fix to bypass damaged tubes isn’t the answer. Of course you can’t be sure from miscarriage that there is a problem with the lining/ womb environment etc. but paired with 17 months of infertility plus unexplained pain, in my mind that points to something causing implantation failure (obviously I’m not a medical professional).

I am sadly not getting on much better. I just had my second failed transfer. I luckily still have 5 embryos left but I am furious I let my consultant talk me into trying again without doing further tests. Apparently with euploid embryos there is a 70% likelihood of implantation per transfer and after 2 transfers that rises to 90%. It was that logic that convinced me to do a second transfer as I felt I would know (nearly) for certain that there was implantation failure after 2 unsuccessful transfers. In my last consultation my consultant recommended we should try a hysteroscopy and endomeTRIO test if we had failure a second time. I’m very sceptical about the endomeTRIO test - HFEA marks it as red (meaning bad basically) on its add on rating system and it just sounds a bit airy fairy to me (testing for perfect time to implant and the microbiome environment). I haven’t had my follow up consultation yet but currently my thoughts are 1. Have the hysteroscopy and ask about whether I can have my minor c section niche fixed at the same time (although minor, I highly suspect that is what is causing my spotting and heavy periods) 2. Change to another consultant because I have never really been happy with this one - I feel she’s overconfident and I want someone who has a more careful risk averse approach. 3. I may bite the bullet and just do the laparoscopy. The main thing stopping me with 3. Is the expense but I have just spent 6000 on 2 transfers that were bound to fail and I could have spent that money on the lap and still have my two best embryos.

The other thing that has come to the front of my mind since this second failed transfer is that I only have one blocked tube. The other one was “slow to fill” on the HyCoSy but was otherwise healthy looking. So perhaps the issue has been implantation failure the whole time.

I’m left feeling frustrated with the whole experience. I “knew” this would happen all along and I so wanted my consultant to prove me wrong.

Hopefully that gives you some assurance you are making a good decision. By the way there is a pre laparoscopy test you can do called Receptiva DX which looks for some kind of marker for endometriosis from a biopsy. It’s a relatively new test so I don’t know about the efficacy but worth exploring if you haven’t come across it.

Keep me posted and I’ll do the same

xx

Not postal - meant prostap!

@Lucy040288 I ended up ordering Doxycycline antibiotics from Superdrug online pharmacy - said I was going to India! That would be the treatment so thought I would make sure, tested negative for it after.

I’ve not been successful yet- but currently on my final embryo transfer so trying to stay positive! My son was an ivf baby so I’ve always struggled with fertility, was unexplained for years and eventually PCOS diagnosed before the ivf for my son. I had ivf last year and had 3 early losses from it which got me wondering about my pain / heavy periods. I had an infection in childbirth which can leave behind adhesions / endometritis, so all this led me to dr Griffiths. Turns out I had ‘colossal’ endo, adenomyosis, asherman’s syndrome and adhesions. None showed up on the 20 odd ultrasounds I had so I wouldn’t rule out based on ultrasound. I first had an MRI which indicated it was all there, then the laparoscopic surgery to remove as much as possible last December. Been healing since! and I’ve been on 3 months of prostap to calm inflammation before this last transfer.

I’ve also been with dr Shehata re. Reproductive immunology - might be something to look into if high markers for inflammation found? Or the postal down regulation, before any IVF.

lot of info there! But as I say - you know your body best and if you’ve had a loss as well as pain, may well be worth investigating further. Get a specialist consultant and start with MRI as less invasive. I’m lucky I could go private with Bupa through work. But I really wish I’d done this testing first - as I wouldn’t have spent £20k and wasted 3 healthy embryos that would never have worked given all the things I had going on! So I get it - get things resolved before ivf is my 2 cents x

I’ve just read your recent update; I’m so sorry to hear of your loss - that must have been devastating. And could well be a result of what’s going on in your uterus. I had multiple early losses and it’s because of all the conditions preventing successful implantation. Really can’t recommend dr Griffiths highly enough x

Having paid over £20k in ivf treatment last year, and THEN having laparoscopic surgery which found adhesions, endometriosis and adenomyosis- I would recommend getting the lap first. I had countless ultrasounds which showed nothing - it’s not usually used to diagnose these things. If you’re based anywhere near south wales, I’d highly recommend dr. Anthony Griffiths.

have you ruled out endometritis infection? Worth getting a course of antibiotics maybe as this was a concern for me also. Best of luck x

Sorry to head of your losses. Infertility & losses is heartbreaking. The pain of Secondary infertility is not acknowledged much.
I may be mistaken, but I thought ‘pregnancy’ was only detectable (via a pregnancy test rather than a blood test) once implantation has occurred. So if you were testing yourself with a traditional pregnancy test, and getting positives, then it would suggest implantation was occurring?

my breasts do get very tender around ovulation and before periods

I had emergency c section in Oct 2011 and gave birth naturally in June 2013.

could you right sided pain be ovulation pain?
i only started to get distinct ovulation pain after i had a baby (via EMC). And yes we never managed to have another (we did have a natural conception though it ended in A missed miscarriage). But I dont put that down to the C Section - just being 5 years older and in my late 30’s.
go for the IVF. It’s
too late for us now, I wish we had.

@Lucy040288yes I can’t believe my little one is nearly 3 now. I found her 2nd birthday tough as I had expected to have had another baby around that time but wasn’t even pregnant. I will try not to let it get to me so much this year but I expect it will be hard not to think about it. I hate having any plans several months ahead as I always think “maybe I’ll be pregnant by then” and then it gets to that date and I’m not.

yes, the consultant that noticed the niche (I had several scans before anyone saw it) said it was a possible cause of spotting. And having looked it up I do wonder if that is the culprit as opposed to adenomyosis as there has been no sign of the latter.

Sounds like most clinics are taking the same approach of fast forward to IVF these days. I also feel like my consultant has brushed over my period symptoms. I hope I am wrong but I can’t help thinking that is an indicator of something else being wrong.

I am with the Evewell in London. So far I have been pleased with them. The IVF cycle was very well managed and closely monitored and they took a lot of care afterwards as I was at high risk of OHSS.

Best of luck with it all. I will try to remember to check in on here with an update when I have one as I know it’s interesting to hear how people get on!

@Lucy040288to answer you q. my daughter is 2 years 9 months so just a couple of months younger than your little one.

@Lucy040288i don’t have any pain but I have very heavy periods and pre and post menstrual spotting. This was why I wanted a lap to check for endo. However, my consultant advised my symptoms were more typical of adenomyosis. The latter is often detectable on scans but she has seen no sign of it so has advised if I do have it it is a very mild case. I also have a very mild c section defect but was advised it was very unlikely to affect things. If this next transfer fails the consultant has recommended a hysteroscopy and “endomeTRIO” test. Has your clinic recommended that latter?

I agree with you that it is better to investigate properly first. I think if I had been younger I might have pushed for more investigations before doing IVF but I was just so panicked by the thought of my eggs getting older all the time. The IVF was eye wateringly expensive - much more than I expected. This was mainly because I was lucky to get lots of embryos and because I chose to have them tested for chromosomal abnormalities it literally doubled the cost of the IVF (as you pay to test each embryo). So it is a big financial decision and ultimately a gamble. And one that hasn’t ended yet as it is around 3k per frozen Embryo transfer.

Can I ask which clinic you are with and do you think they are good?