Infertility after c section

@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?

Just to add generally, I wanted a natural birth but had an elective c section as I was advised I was more than 50% likely to finish up with a c section if I was induced or went into labour (won’t go into details as not relevant here). However, I was never made aware that secondary infertility was a risk of c section. Many doctors tell you c section is much safer. I do wonder whether with more and more people having c sections, in a few years we will be more aware of the risks of damage to the reproductive organs. I am regretful of my decision to have an elective c section now for obvious reasons.

@Lucy040288bumping this tread as reading your post I did a double take to see if it wasn’t me who had written it a few months ago! Also TTC since Jan 2024 for my second baby after c section. After 9 months and several scans that showed nothing I went to a fertility clinic and did a hycosy. They found my right tube was closed with right ovary immobile and stuck to my uterus. Left tube appeared healthy but was “slow to fill” on the test. Was pleased initially as thought they had finally found the problem and cleared my left tube and so I would get pregnant. 3 months later and no success and I was back at the clinic and they recommended IVF. Like you, I wanted a laparoscopy to check for endometriosis. However, my fertility consultant advised against it. Her take was that it was my c section that had caused adhesions that were blocking my tubes. She said a laparoscopy risked further scarring and was not recommended without a proper reason to do it. Fast forward and the IVF cycle was very successful. I am lucky to have a high egg count so finished up with several good embryos (which I had PGT-A tested due to being 38 and more than half were genetically abnormal so the add on was worth it IMO). My consultant was confident in my prospects but my first transfer failed. We are going to do one more transfer and if that doesn’t work, she has recommended further investigations to see if anything else is wrong. It is a tough decision and a huge gamble but at least having done the IVF I have “banked” a few healthy embryos. Time is critical the closer you get to 40. Have you had any luck since you posted?

@Lucy040288
there were no blockages found - I had a HSG done after my first ectopic- but the doctors were honest in that there is no test which can prove either way whether a tube is damaged internally/externally and no longer functions - the only way of knowing would be to get pregnant with a baby in the right place.
in fact when they removed my first tube they said visually my remaining tube looked “perfect” - but I went on to lost it pretty much on the next pregnancy

if you’ve been having chemical pregnancies post c section it’s entirely possible that these were in fact ectopics which you me body managed to resolve itself

Yes I was left infertile after a c section for my eldest child. Ultimately scar tissue caused 2 ruptured ectopic pregnancies and I had to spend £40k on IVF to conceive again. It can only be related to my c section as post c section I would have the most horrendous pain at ovulation to the point I’d have to take a sick day from work and my stomach would swell. When they operated for my first ectopic they found a lot of scar tissue and my ovary was stuck to my bowel. They did do an adhesionectomy but I still went on to have the 2nd ectopic

Its hard to know what caused the tubal blockage.
C section scarring can potentially cause scarring of the womb affecting implantation . Scarring of the tubes themselves tho from c section , while possible the risk is considered very low risk.
it's possible to have had an infection after the surgery also which is quite possible. Or , it could simply have always been there. I conceived despite quite a severe tubal blockage and you'd never know it was there. It doesn't always produce symptoms and and it was only after pregnancy that mine became bothersome . I only knew it existed prior due to fertility investigations

Just 1 tablet from Holland and Barrett sorry I can’t remember the dose. I think it was what was advised in Its Starts With An Egg book. Or some instagram account