anyone have infertility due to adhesions after cs and is clomid any use if ovulating?

[muppety]

Hello. Bascially I had an elective cs 2 years ago and did bleed a lot during the op. Have now been ttc for 18months. I have seen a specialist who said that its very rare for cs to cause infertility as does not tend to cause problems with scar tissue and blocked tubes. To be honest I was really sure that was the problem before I saw him. Also he suggested clomid but I know I am ovulating as cycles reasonably regular and have done ovulation sticks and had normal blood tests.

So what I want to know is will clomid still help even if I am ovulating? And could I have blcoked tubes post cs? I would welcome anyones elses experiences!

I may have something similiar, had a cs but went on to conceive twice but the last one resulted in a m/c and haven't been able to conceive since (about 18 months). In order to rule out everything I've had loads of tests, eg blood, semen (for partner!), and an hsg. The hsg is basically dye injected into your uterus and they watch how quickly your tubes fill up. Mine show a delay on left hand side so I'm now on a waiting list for a laperoscopy which is an operation under ga to have a detailed look at tubes. If anything can be removed they will do it there and then and hopefully 'clear' the tubes. Can't see the point of going on clomid if you are ovulating, this won't help at all if you do have blocked tubes. Think an hsg will rule this out one way or another.
Have to say, from what I've heard, it is very unlikely to get blocked tubes from a cs, they think an infection I had post cs might have caused my damage (if indeed there is any). Hope you get some answers though as it is very frustrating. Good luck.

Hi. I too had a cs 22 months ago. I've been having trouble ttc too. My cycles have changed and now I get my af about 8 or 9 days after ovulation due to low levels of progesterone. I'm waiting to see the nhs gynae but my gp thinks I will be given clomid. I'm pretty sure that I ovulate as my charts and cm indicate this. They do give it to people who ovulate, as, as my gp put it 'clomid regultes your cycles and can kick start a cycle that has fallen into a different pattern'. I'm hoping that when i see my specialist that's what he prescribes. Good luck and hope this helps

Temp charts and cm indicators can well be wrong, blood tests should be done and repeated to see whether ovulation is happening or otherwise.

Any abdominal surgery can cause adhesions to form post op, it is not uncommon for such problems to arise post c-s or after any abdominal surgery. Drug treatment will not touch adhesions once they are formed, surgery is needed to cut them out.

Clomid should not be given if it is proven that ovulation is regularly happening as it can have the reverse effect.

I would again go by the results of blood tests (however if such test results are more than six months old they should be discounted) rather than opk's as again these can give misleading results.

Was wondering why a HSG has not yet been done as this is a tubal x-ray and a useful test to have. This would tell you whether your tubes are patent (open) or otherwise.

Hi just thought I'd add my experience to this!

I had difficulty conceiving after an emergency c-section 6 years ago. I had an HSG (I think you should push for this as as far as I am aware it is the only way to tell if there is a tubal blockage and depending on the results of this a laparoscopy may be advised to check out the condition in more detail).

It was discovered that both my tubes were blocked and I was advised to have a laparoscopy. I had this and they discovered that scar tissue had blocked the tubes - they cut it all away and opened the tubes.

I have just given birth to my second DD!!

Good luck & hope it works out for you.

HSG's are also useful for another reason; deformities INSIDE the tube can only be seen on x-ray.

Attila, don't quite understand your last post. After my hsg they said there was a delay in left tube filling with dye but would only be able to determine why this is by a laparoscopy, ie the x-ray couldn't show what was wrong with the tube. Do you disagree? Would love to save having the laparoscopy done!

Hi. THanks for all your replies but now I am really unsure what to do!

My day 21 progesterone was 40 which does indicate ovulation. I have had a normal uss. I have to go back to discuss laparoscopy or clomid as next step. A HSG sounds better though but he did not mention that. Plus he seemed to think clomid would help despite ovulation but now I am worried about making the right decision. Perhaps I should go for the laparoscopy as the only thing that has changed since my last preg was the cs? I am now 35.

Its just so frustrating as I am surrounded bu friends who all seem to get pregnant the first time they ever have sex!

Muppety - I don't think you'd need the clomid if you ovulate regularly. At 35 you're also young enough to be able to afford the odd anovulatory cycle, which is what the Clomid would prevent (but even that can only be taken for 6 months at a time).

Re getting pregnant the first time, why, oh why, do women do this to each other? I'd wager that half the ones who say it happened first time were actually ttc for a while. (Statistically at least it would make sense.)

Thanks all.

I am going to ask about a HSG but I think a lap and dye may do that and a little more. I have read a little about clomid and I think for me it is probably not the right thing to do. Its a shame though as I am scared of being 'unexplained'. Somehow that seems harder than having a cause found.

You do not want an operation if it is unnecessary - a HSG may give the answers that are required. It is little point for them to do a lap if it is to be used just as a test rather than a treatment. I would certainly ask them more questions re this before you go ahead.

Unexplained is no diagnosis at all; all this means is that they have failed to find out what is wrong so far. Sometimes this "diagnosis" is given to patients when some tests have been missed out.

Have you considered seeking a second opinion, this may be an idea for you to consider now.

Janus - sorry only just seen your message. HSGs can show deformities inside the tube - kinks etc. It does not detect endometriosis deposits or adhesions - this is what they lap would do. I would certainly ask them beforehand what they intend to do during the lap and what follow up care you will receive post op (they need to go through with you in some detail what was found).

i had a cs 2y ago and have since had 4mc and 1 ep, during the lap to remove my ep they found that my remaining tube is covered in adhesions, i am currently waiting for af so i can have an HSG asap, tbh tho it seems quite a common prob. cs is major surgery and this is unfortunately one of the drawbacks!

lissie, after my hsg they thought I may have adhesions or endometriosis but this doesn't show in hsg, hence the need for a lap. Once they are in they will then remove anything they they come across. Have they offered to do the same for you? I suppose the hsg will show how well the dye flows through and then they can assess. However, at least there is something they can do if it is blocked, I took comfort that there is some hope.

I had a cs in November 2004 and then an ectopic this past December. Lots of internet sites and books do talk about a possible link between the two although my consultant denied this.

She said she'd do the HSG if we had problems conceiving, which for me could mean another ectopic I guess! Am going to see her in a couple of weeks because I just don't feel comfortable taking that route, I know HSG's aren't perfect but at least it will tell me something.

Thanks Attila, all for the comments here, a helpful thread.

Hi.

I assume the lap would be to look for and possibly treat any adhesions I might have? I will ask re HSG though.

Are you by any chance a doc Attila?

I had secondary infertility after a CS (although CS had nothing to do with it)

I was ovulating fine .. but my consultant made me chart for 3 months (pinpointing date of period starting, date of ovulation .. using predictor kits.. and dates of sex)

took her two seconds to identify that I was ovulating too late in cycle (and my 21 day progesterone test was fine too) .. I was ovulating day 23 in a 28 - 32 day cycle .. one needs about 10 day luteal phase (length between ov and period starting)

basically consultant explained that when you're pregnant your hormones get basically thrown up in the air .. and when you are no longer pregnant they land

she said sometimes they need a boost-start .. so gave me low dosage clomid .. conceived DD first cycle

hope that makes some sense to you .. I think I'm saying try charting for a few months first

Thanks twiglett that has given me hope. The consultant is very nice and I think I trust him so fingers crossed!