Laparoscopy for adhesions caused by c-section. Anyone had any success?

[haribofan]

I've been ttc for 15 months for no.3. Have had a failed IVF this Summer. Now it seems my ovaries are in totally the wrong place and I have adhesions from my second c-section. I'm really angry at the clinic for not pointing this out before doing IVF (I had plenty of scans before) but anyway, I've now been referred for a laparoscopy. I cannot believe I've been ttc for all this time and my ovaries are probably nowhere near my tubes- arrrgghh!!!
Anyway, I just really wanted to find out if anybody had been successful with ttc after a lap?

My sil has had 3 sections, no problems. Have your cycles and periods been regular? Were you diagnosed with unexplained subfertiity?

Sorry you are going through this.

Do you suffer with other symptoms of the adhesions? Is it Ashermans Syndrome?

I had AS following the cs I had with my DD. It took a long time to have it diagnosed. I did have other symptms beyong inferrtility - lack or very light periiods, a lot of monthly pain, etc. I have now been treated. I had two hysteroscopies and during them the consultant removed the adhesions. Each was followed by quite intense hormone replacement tablets. The ops appears to have been successful in that the adhesions have gone and I no longer suffer from the pain.

There are lot of posts here on MN from when I had my ops, etc.

There is also a Yahoo group for AS with lots of positive stories of people going on to have successful pregnancies afterwards.

Were you ovulating? Sorry for questions. Just trying to establish whether you could file a lawsuit against the pct in charge of your care during labour, childbirth and of course c section

Adhesions are a side effect of any operation, not just c sections.

Mine were diagnosed after interanl scans and hysteroscopy. External scans didn't pick them up at all.

Mine were only investigated after a couple of years of me after the onset of symptoms - and not after infertility checks. It was when I saw a consultant at my hospital who has written papers of AS that my dx was done.

'Just trying to establish whether you could file a lawsuit against the pct in charge of your care during labour, childbirth and of course c section'

On what grounds? The consent forms you sign state that adhesions can occur, and, as pointed out, this can happen with any operation. It's not an indication of negligence.

Agree expat; somewhat about the thought of bring a lawsuit.

Surely it is more important for haribofan to be considering her options of how to have the adhesions treated and hopefully removed than being advised on wheter she could sue.

I actually read consent forms I had to sign for other surgery - not CS. I've had 7 surgeries in total now. Not a one that didn't mention adhesions as possible side effects .

Hope you get some answers and help, haribo.

Sorry should have included a few more details in my op. This has come about after a HyCosy procedure which I asked the clinic to do after the failed IVF. I just needed to know for sure whether my tubes were blocked or something as trying naturally is getting so demoralising. Expected it to come back all clear as have had this procedure done before getting pg with DC2 too. But no, one tube is OK with the dye coming through. The other one they couldn't tell. The problem is that between the 2 HyCosy's (i.e. as a result of my 2nd C-section) my ovaries have been put back in a very strange place so they are very to see on scans and would likely make conception trickier as the tubes might not be picking up the eggs. No idea whether I'd have a case for a lawsuit but wouldn't want to go through that.

I have no pain at all. What is Ashermans syndrome Hula?

Asherman's Syndrome is intra-uterine adhesions. Most commonly caused by a D&C, but any operation on the uterus can cause it.

\link{http://www.ashermans.org/Dr_Vancaillie_s_pamphlet.pdf\Read here.}

Do you know were your adhesions on - the tubes, ovaries or uterus?

They won't know for sure until the op obviously but looks like my ovaries are stuck to something they shouldn't be, my uterus wall I think .

Yes they didn't know the extent of my adhesions until the op either. Think that is often the case. In the end I has several adhesions closing up most of the cavity of my uterus, although my tubes were not affected.

Do you know when and what they are planning to do next and during the op?

Op should be soon after AF arrives, next month I hope. The consultant thinks he's going to remove the adhesions, return my ovaries to the right place (!) and use some anti-adhesion substance as apparently the adhesions come back quite quickly otherwise? Then he says he'll do a quick hysteroscopy at the same time to check out my cavity!! Oh joy, does this sound similar to what you had?

My ops were hysteroscopies, done under GA. The first one was exploratry and the removal of some of the adhesions. Then three months later I had more removed, again under GA.

Have you had your cervical lining measured at all? Hae your periods been normal since your c section?

My cervical lining was very minimal and periods were incredibly light, sometimes none existent.

In order to replenish the cervical lining I was, following both ops, out on a very high dose of HRT for 6-8 weeks, and then also oestrogen meds in addition. This was actually the most challenging part of the procedure as the RT gave me pretty bad mood swings. There is several posts of mine on MN from those times if you wish to know further on that front.

I had a very long wait from dx to op time - was supposed to be 6 months but was several months later than that.

That sounds like a lot to go through Hula. I will have a look in the archives. I've seen some of your posts over my time on here and hope you are successful soon with ttc no.2 :).

On all my scans, the lining has always been thick when it's meant to be and thin when it's meant to be so I guess all is OK there. Periods very average too.

I have totally bought into the idea now that my misplaced anatomy is the main reason we're struggling and I can't see as it'll be that easy to put right!

Sorry to have jumped in head first! Re: the lawsuit etc. That was jumping the gun a bit. Please accept my sincere apologies. I am a lawyer, and we had recently dealt with something along those lines at our practice. Our client was in a similar predicament to the op. Anyway, to cut a long story short, she won 3 free ivf cycles due to AS: having been caused by 3 procedures under the same pct. I should not have assumed the op here was wanting a similar outcome. I made a huge mistake, and hope you ladies can understand that. It's just that sometimes, coming in from work, we have a distorted perception about what people want( because obviously at work, everyone who walks through the door wants to file a lawsuit!). Hope everything goes well for you haribofan. Good luck hon x

Aw, fedupttcnosuccess I wasn't offended at all. TBH it's certainly something that's run through my mind as when everything else seems ok, I often wondered if my C-section had been a bit botched. I just think the long timescales involved in something like that and the added stress wouldn't be worth it. All I want is a little sibling for my other 2 DC whom I'm extremely lucky to have.

Saw you on a thread the other day fedup- I hope you are successful very soon.

thankyou very much haribofan. you are too kind. yes, we're actually going through a rather stressful time at home and work. since my discovery of mn, it is a good outlet to try and gain some perspective! good luck hunni x

just out of interest, haribofan:was your ivf cycle done privately?

Oh yes, private. I don't think any pct in the country would do IVF for a 3rd child. And rightly so I guess (although the desire is no less strong as before most of the time).

I can empathise with that desire totally. As the ivf was done privately, the onus was on them to conduct the investigative tests properly to ensure the success of their procedure. As this has clearly been an oversight on their behalf, once you have had the corrective operations completed, I would ask you to get in touch with the people in charge of your IVF, and ask if they could offer you another cycle as a gesture of goodwill considering the findings of these subsequent findings. I am only thinking of you. As far as I can determine, from more experienced ladies on these threads than myself after your op you are more likely to fall pregnant. Hindsight is a wonderful thing, if this had been performed before the ivf, you almost certainly would have had a greater chance of success.

Yes am angry with the clinic as they have constantly moaned about scans being difficult because of the position my ovaries have now been moved to. However, when I've pressed them, they always said it wouldn't affect my fertility. I don't think they'll give me a free go but just don't trust them now. Trouble is they're just down the road and the thought of trekking further afield to London for scans and stuff probably would prove too tricky with 2 DC :(. Trying not to get too angry with anyone though and just look forward to this op but not easy as you'll know. I'm not sure the IVF was effected by my ovaries' positions as IVF bypasses this anyway (although they did have great trouble in getting to my ovaries at Egg Collection)!

Ivf is a one size fits all approach on the nhs. Inspite of the teams of docs being the same, I understand their care is more tailor made to the individual, i.e. Working around your cycle, rather than trying to fit you into their diary. Therefore their motivations should have had your interest at heart. I'm not saying they didn't, just that that if you needed any corrective surgery then it should have been performed beforehand. I would still, once you have recovered from the procedures, discuss your feelings with the ivf specialist who dealt with you. If nothing else, I am positive you will get some concession or greater understanding for your next attempt. There is a complaint procedure, and you may stand to benefit from it. But if you are certain that you don't want to pursue that path, then that is entirely your choice. This is why the medical procedures are so costly in this country- they ARE answerable, inspite of what they may like you to believe. Whereas, in some European countries the criterion under which they work are dubious, and also they don't necessarily have the scrutiny of patients or outside bodies. Sorry for the long post.