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

@HPriorjust saw this thread, sending huge congratulations, you give me hope 💛🌟. Hope your pregnancy is going well and sending you all the best wishes

So an update... I had a NHS follow up appointment yesterday following contact with them about my private scan which identified the niche.
The doctor was suprised it wasnt picked up on my hycosy a year ago. She looked back on the report, which all reported normal. She looked at the scan images herself...and there it was clear as day!!! She was very apologetic. Said this shouldn't have happened and should have been picked up. A whole year wasted!! She has referred me to the UCLH for a repair but said this will take a very long time and in the mean time to do IVF and freeze my eggs 😔😔 just don't know what to do now x

@ChaE05 I’m sorry that it wasn’t picked up before. However, it’s amazing that the doctor has taken it seriously and said it needs repair instead of fobbing you off and telling you the niche won’t affect anything and just to do IVF. I suppose doing egg collection depends on your age and how easily you conceived before. Could you look into paying private for the repair to get it done quicker? Are you looking at lap repair or hyst? X

@Lucy040288i know !! I was full expecting her to say sorry nothing can be done. Tbh, I really dont think i want to pay so much money for IVF at my age (39) have seen so many around me with poor outcomes. Its such alot of money. I think I would prefer to look into having it repaired privately. Im going to at the very least find someone in london and book in to have a consultation to get their specialist opinion on it and find out if I would need a hysteroscopy or laparoscopy x

If anyone can recommend any london based surgeons that would be great 🥰

@ChaE05paying for IVF because you have to wait for a repair makes no sense. If you only need a hysteroscopic resection it’s a day case - would cost a lot less than IVF especially as at 39 you are going to be recommended to do PGT-A testing which really adds to the IVF cost if you are lucky and get a lot of embryos. A laparoscopic repair would cost more than a hysteroscopic one I expect as it’s a more major operation but I’d be surprised if it was more than IVF. IVF is about 12k minimum in London now and at 39 people often have to do more than one round. Also each transfer is about 3k. Re surgeons in London who do c section niche repair try Mr Ertan Saridogan, Mahantesh Karoshi or Adrian Lower. There is also a Facebook group on niches where a lot of comments recommend surgeons so may be worth a look. Good luck!

@ChaE05PS to find out whether you’ll need hysteroscopy or laparoscopy for the repair, you’ll need an MRI and possibly a hysteroscopy to look at the niche. But your consultant should advise as to what next steps are to investigate the niche before the necessary surgery is decided on.

Heyyy, how is everyone doing?
Have just had my consult with Dr Saridogan, found him to be very lovely. Basically he is unsure that the niche is what is causing me not to fall pregnant. Fluid has never been noted in any of my scans and also said inflammation is not always present. Only in 1 in 4 (which still seems high to me). He said if I have had fluid present then he would be keen to repair. He suggested that I go for IVF as believes there may be more of male factor contributing. Partner has 19% dna frag. And also morphology has always been between 2-4% but motility and count always very good. He said it is ultimately my decision but he feels my RMT is sufficient enough for a hysteroscopy. So now im even more confused as to what to do. He was more concerned about not wasting time due to my age x

It may be worth comparing the cost of IVF and a hysteroscopic repair. The repair is likely to be substantially cheaper by the time you have done PGT-A testing of the embryos which you will be advised to do because of your age. For some reason these fertility doctors seem to be very biased in favour of IVF as a fix all. Whereas in my experience, actually finding and fixing the problem seems more logical!

@ChaE05 you could spend all the money in the world on IVF but it won’t work if the endometrium isn’t receptive. I think I’d go for a hysteroscopy and CD138 stain as a minimum to make sure there’s no inflammation before spending thousands on IVF. Of course, you could do IVF and get pregnant straight away. It’s a difficult decision to make. I just knew something wasn’t right in my body and knew IVF wouldn’t work.
I’ve still got a bit of pain 3 months post lap repair. Not sure if it’s normal or not. My surgeon said he didn’t think imaging post repair would offer anything as it’s about the functional outcome (getting pregnant) that matters. X

Thanks girls. The hysteroscopy is going to cost about 7k total. If I paid for this IVF would be off the cards. I just cant afford it all. Ugh I dont know. Its so hard to know what to do. I find the c section scar defect group even more confusing..as a real mix of women. Those that have concieved without repair. Those that concieved after. Those that had repair and still cant concieve. And those that have had to have a second repair !!
Part of me doesnt want to do any of it and what will be will be. Just want this longing for a second child to go away x
@Lucy040288how long until you can ttc again? Have your symptoms gone? What sort of pain are you experiencing x

Look into treatment and ivf in the Czech Republic, better success and much cheaper.

If your husband has DNA fragmentation then IVF and PGTA testing may well be necessary for you.

I think it could be well worth looking into freezing embryos now (due to your age, so as not to waste any time as the doctor said), and then transfering them after niche repair.

I agree if you go abroad to do the IVF it will be so much cheaper. You may never end up transferring any embryos, but it gives you a valuable chance, that you may not get in the future.

@ChaE05 whereabouts in the UK are you? My hysteroscopy (not niche repair) under Sam Dobson at The Park in Nottingham cost £4k. Is it worth shopping around to see if you can get it done cheaper?
I’ve got dull aches and strange stinging pains in my abdomen. I don’t think I’ve got the same right sided pain as I had before my laparoscopy but I still don’t feel normal. We have to wait 6 months so December we can try.
To be honest, I think I’ve resigned myself to the fact we won’t be having another baby. It’s been a long exhausting journey. I’m also so angry at what I’ve had to go through. I think I probably need to get some counselling.

@Lucy040288im honestly so sorry you are feeling this way but I COMPLETELY understand. Im actually not sure i want to go through any of it. Finances being such a huge concern.
Dr Saridogan says he can perform hysteroscopy but everyone telling me laparoscopy is best. But there are so many reasons this cant be done for me right now. We have just bought a house. I would be out of work for a while as im cabin crew. So would be a huge financial hit. Plus I cant even lift my toddler 😢 it would be near on impossible for us.
And all the while not evening knowing if its the right direction to go in? I literally feel like Im guessing if ivf or repair is the right option. Its just madness. I hate what this infertility has done to me. I hate how small my circle has become. How bitter and sad ive felt. Im probably about 70% sure i dont want to go head with any of it right now. So I do completely feel you. You've been through such alot. Should we just be counting our blessings and just feel gratitude for our darling children. Its beyond tough. Im so so mentally done with this rollercoaster and want off. Sending you loads of love x

@ChaE05 I was actually really hopeful when the niche was found that it may solve all my problems but seeing how many failed lap repairs there are on the Facebook group have made me very cynical now. I genuinely wish I could have had the less invasive hysteroscopic repair. If your RMT is good then that is the way to go. Lap is a lot more invasive and takes a lot longer to recover from. I’m sick and tired of being in pain.
It is so hard and I get it. I would love to have a baby bump again and feel that little baby moving inside me and the amazing feeling when you hear them cry when they’re born and all the newborn snuggles. But yes like you I am so bitter. I think I would feel differently if it was because my egg count was very low or there were other factors but there isn’t and that’s very hard to come to terms with.
Maybe you need to speak to someone as well about how you’re feeling. It’s just so unbelievably hard. Thank you, sending you lots of love too xx

@Lucy040288this is what im finding so difficult...the group has such a mixed bunch of people and experiences with their defects. Like the Dr said to me... niches are so common and for the majority of people they dont cause any issue at all. But for a small number it can cause issues including infertility. I think this fb group makes you focus on the niche always being the root cause of infertility.... because most in there are struggling to fall pregnant. But the reality is there are all those women out there that are walking around with a niche, getting pregnant with a niche they dont even know they have one. There are many women in the group that have concieved without repair and many that are still unable to concieve with repair. Its extremely hard to know what to do when you are so desperate for a child and think...maybe this is the issue. Maybe I have found the reason?
I had no idea my son may have been my only child. What do you mean I wont feel the flutters in my belly again, that i wont experience breastfeeding again ( was my fave thing ever) or baby wear again. That new born smell.
Would I have appreciated it more if i knew it was my one and only time? Its just too much for my heart to take. Too much for my relationship to take at times.
I have just had to unfollow someone now on insta as they have just announced their 3rd pregnancy. I just cant see it..need to protect my peace x

@ChaE05 I think we need to remember that everyone is so individual. I do believe my niche is the cause though as mine was so severe. Apart from one blocked tube I have no other issues. But yes many women with a niche don’t have a problem at all but I think a lot more women do have problems but there just isn’t the evidence out there yet.
I know. I loved breastfeeding too. I felt so guilty when I had my little girl that I’d taken my pregnancy for granted and didn’t enjoy it as much as I should and couldn’t wait to get pregnant again. I only have 1 bump photo and really regretted not taking more bump photos and thought I would get another chance. Life can be cruel. And yes it does put a strain on your relationship. I know exactly what you mean, my cousin’s girlfriend has just had their 3rd baby via c section and I met the baby on Saturday. It completely and utterly broke me. I just don’t understand how she can have 3 sections and be perfectly fine and I’ve been left in such a mess after having 1!!! I’m so so angry and exhausted from it all. I’m just so sorry you’re going through this as well. I just want this nightmare to end x

@Lucy040288of course, this niche could absolutely be our problem and I really really do hope this works for you. Bring on December when you can TTC again 🥰

So hard meeting little babies. You're so brave and strong even if it broke you. It takes alot to me in that situation. I was at family gathering at the weekend on my partners side. One of his cousins also has a new baby. I said hi, gave my congratulations and moved on. I couldn't be near the baby and I absolutely didnt want a hold. And I just know this pain isnt going to end because I know there are many more family members/friends that will be having 2nd/3rd babies. Its just a pain that doesnt seem to go away. Feel so sad deep inside.

I really dont think I'll be going down the IVF route. I cant spend all that money on it for it to not work. Also I would go abroad, so the planning for that and having to think about my son. Its all very stressful. I think the hysteroscopy would be the easier option and I would really like to know if there is inflammation in there. Just feels strange going against the dr advice. X

@ChaE05 well I’d managed to avoid him for a month since his birth but couldn’t avoid it any longer. I know it’s not their fault and it’s not the baby’s fault I’m in this position. Just hard being happy for people extending their families when it’s something we want so much and didn’t realise it would be this difficult. it does eat you up inside.
I’m sure you could have an endometrial biopsy or pipelle to test for inflammation with the CD138 stain without having to go through a full hysteroscopy. It could be done in an outpatient setting without general anaesthetic. Might be worth doing that? Or having an endometrial biopsy when you have the hysteroscopic resection? It is so hard to know what to do. X

@Lucy040288i just feel if im going through a hysteroscopy and paying out for that i should probably do the whole lot just to cover all bases. I must admit the thought of going under petrifies me. Its the one thing that really puts me off as will be the first time in my life. Just feels so different when you know you have a little one that needs you. I know...we cant avoid family and friends forever but its so triggering x