Infertility after c section

[Lucy040288]

Hi

Just wondered if anyone had any experiences of infertility post c-section. I had an emergency c-section in July 2022. I started having some right sided abdominal pain about a year later. We have been trying to conceive our second child since January 2024. I went to the GP in June 2024 and had a transvaginal ultrasound which was normal. In September I went back to the GP and we had bloods and investigations and referred to fertility. Bloods and husband’s semen analysis all normal. I had a HSG in March 2025 which did not show any spill of dye from right tube indicating blockage. I’m wondering if I should have a laparoscopy to see what’s going on but my consultant says they don’t usually do laps that often anymore and go straight to IVF. I just don’t want to do IVF for it to fail and then have a laparoscopy and find a problem that could have been sorted meaning we could conceive naturally. Obviously we would have to pay for IVF as we already have a child. Also, I don’t know what could be causing the right abdominal pain. Could it be adhesions, endometriosis, the blocked fallopian tube??? Some months I’ve experienced extremely tender breasts in the 2 week wait but then came on my period so I don’t know if that could mean the egg’s been fertilised but unable to implant due to inflammation or this blocked tube?! I think I had a couple of chemical pregnancies last April and June as I had very tender breasts and a faint positive pregnancy test but then period arrived. I then stopped testing as it was too upsetting. I didn’t have any problems conceiving my daughter. I just don’t know what’s going on or what to do for the best.
has anyone been through anything similar?

x

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

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!

@HPrior Yes, I do think that there must be something wrong. It’s a strange feeling, of course I’m devastated but I know that I can get pregnant, it’s just making them stick. My consultant seems to think my miscarriage was more likely to do with chromosomal abnormalities but I’m really not so sure. Of course I know that egg quality declines with age but my eggs can’t have deteriorated that much since I got pregnant with my little girl!

I’m so sorry you’ve had another failed transfer. That must be so heartbreaking for you. I can understand why you went for it and of course you want to put your trust in the medical professionals but I also think you have to advocate for yourself and push for answers. I also completely understand why you’re furious. It’s not just an emotional drain but a financial drain for you. Like you’ve said, no matter how good the embryos are and what the chances of success are on paper, they’re never going to implant if the uterine environment isn’t healthy. It’s still a positive you’ve got 5 embryos left but I think you probably need to get to the bottom of why they’re failing.
It’s so hard knowing what to do for the best isn’t it and it goes round and round in your head constantly. Could you have a laparoscopy and hysteroscopy at the same time? Maybe stick with your consultant for the next investigations as she knows the history? Or could you make an appointment to see a gynaecologist? Not just a fertility consultant who’s focused on IVF, but someone who may look into your symptoms further and possibly be more helpful as the focus isn’t just on getting you pregnant but on finding out what’s wrong?

That’s really interesting about the Receptive DX test. I had been reading about CD138 to test for chronic endometritis as they can do a biopsy when they do a hysteroscopy to test for it. Do you pay for the kit? It may be worth a shot! What have you got to lose!

I’ve actually been given a date today for my laparoscopy as well which is next month! Part of me is relieved but a big part of me is absolutely terrified.

Hopefully one day we’ll get some answers 🤞 xx

@PyroDonkey thank you for sharing your experience! It’s great to hear it worked out for you! I’ve been given a date for my surgery today and thankfully I don’t have too long to wait as it’s next month. You know your body don’t you and can sense when something isn’t right. I must admit I am terrified of having it done but I think it’s the only way I’m going to know what’s going on.
Congratulations on your pregnancy! I hope it all goes well for you! It’s lovely to hear a positive story!

@MotherOfShihTzus thank you! That’s really helpful, I will look him up! X

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 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 🤞 🤞🤞

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.

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.

@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 ☺️

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.

Also @seven201what do you mean by miscarriage testing?

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.

@HPrior so because I was referred to the NHS fertility clinic for investigations, when my HSG came back showing a right block and coupled with the pain I get on my right side, the options were straight to IVF or a lap. Consultant didn’t seem to think my blocked tube would affect anything as it’s blocked at the end near my uterus so hasn’t shown a hydrosalpinx but I’m still concerned my tube may be inflamed due to the pain I get.
If you have private healthcare then I would at least make an appointment to see a gynaecologist for the spotting and heavy periods. They may be able to help? I suspect they may offer a laparoscopy and hysteroscopy? Technically not fertility related as such because you have gynae symptoms that are worth further investigation!

@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 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.

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.

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).

@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.

@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!

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.

@seven201 I haven’t had a saline sonogram, I had a HSG which didn’t show any filling defect in my uterus. I don’t think many places offer the saline sonogram but something to bear in mind. At least you did get there in the end though! Just shows that IVF isn’t always the answer!

@PyroDonkey it just scares me being abdominal surgery and wondering what they’re going to find! Haha, someone told me to down a bottle of coke after the lap and it’ll make you do a massive burp and get rid of the gas! Thank you, I hope so too 🤞!!!

@HPrior my consultant told me that the evidence has shown that it’s better to not bother with investigations and go straight to IVF as it wastes time and doesn’t generally change the outcome. However, that’s all very well if you fit into the majority of women who that works out for but there will still be the minority with issues that need sorting before even IVF will work.

There’s a lot of really helpful information shared here! Lots to think about and look into!

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

@PyroDonkey how long did it take you to recover after your laparoscopy? I’ve had my pre-op and the nurse told me I need a minimum of 2 weeks off work and it could be 6-12 weeks until I’m fully healed! I didn’t realise it was as bad as that! Not sure how I’m going to manage as my 3 year old likes to be carried everywhere 😫!

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