Secondary infertility post c section

[edibletreats]

Hi all,

We have been actively trying for baby no.2 since Dec 2018. I did have a chemical pregnancy in April/May 2019 but nothing since then.

DD1 was born in Sep 2016 and was conceived within 6months of coming off the pill. Very normal pregnancy but developed obstetric choleostatis which then resulted in an emergency C-section. However, the op and recovery was all normal.

I have now booked an appt with a private fertility specialist (nothing offered on NHS) and would be keen to get a sense of what might be next?

I have read about adhesions from C-sections causing infertility and think that may be the case for me as cycles, periods, even ovulation signs all seem to run like clockwork.

I'm 31 and DH is 34. We are generally quite healthy and not overweight.

Just desperate for DD to have a sibling and I would quite like another 2 kids if possible so kind of need to get cracking!

Hello

I am in a very similar situation, I have a 3 year old daughter and am desperate to give her a sibling. I also had an emergency c-section with her.

I got pregnant straight away with my daughter but have been trying for 18 months for a second with no luck. No definitive reason as to why. Had a few tests on the NHS but obviously IVF not offered. I am 33, as is DH.

We have started our IVF journey privately, it’s all happened quite quickly to be honest. The first appointment was so helpful as they explained all the test results, which although were done via NHS no one really interpreted them for us.

Then they said I was good to go with my next cycle. Our I initially appointment was in May and I had the egg collection yesterday. Between May and egg collection I had a few blood tests, scans and about 2 weeks of injections. Appointment times can be a bit unpredictable depending on how things are developing.

Happy to answer any other questions I can 😊

Xx

I had my son via c section in 2009, fast forward 10 years ended up having a ruptured ectopic last year, while they were in there removing the baby & tube the next say the surgeon told me that my scar tissue from section had grown over my remaining tubes in some places! Try push for a hsg xx

@Evey43 did they actually say your issues are related to having a C-section or is it 'regular' secondary infertility

?

thanks for sharing @Evey43. I'd be interested to know what tests you had that resulted in them recommending IVF?

@Ginger89 this is what I am worried about. I have had an internal scan which showed normal ovaries/follicles and uterus. So I am thinking it might be the tubes...

@edibletreats I am yet to have my baby and I have some tube scarring (diagnosed by a HSG), I don't have endometriosis and have never had an STD so it can be naturally occurring. I did have a natural pregnancy after the scarring was found so don't give up hope. A HSG is probably the best next step for you if the NHS will oblige

@Pinktruffle no they didn’t specifically say that it’s due to my c-section but they didn’t say it’s not that either. They just my pelvic ultrasound was normal but I don’t know if they looked at my tubes or not. The private consultant said sometimes they can accidentally ‘nick’ something during a c-section.

@edibletreats I had a pelvic ultrasound and a blood test on the NHS. Both came back as ‘normal’. AMH wasn’t included so I paid to have that done myself which was a bit low at 7.8, DH had 2 semen analysis’ done on NHS but no one interpreted them (so what’s the point).

NHS didn’t recommend IVF as such. When I went back to ask for more information re the semen analysis result and ask if an on-going ache in DH testicle could be an issue her exact words were ‘you’re going into too much detail, you won’t get any help if you want IVF’. That’s when we decided to get a private appointment initially to interpret the results for us and discuss options and they recommended IVF based on all results together.

Agree with pink truffle , HSG would be the best next step, when I had mine before I had it done they described my tube as “tortouse” (full of twists & turns) & “adherrent to previous c sec scar tissue” the hsg was painful I must admit but pain only lasted a min or so the ink getting pushed through actually indone any twists (probably why it was painful) and it was clear no blockages, I’m still yet to fall pregnant again to be honest havn’t really full throttle ttc as it’s taken me a year mentally to recover but at least I know my tube is ok. Hope this helps x

@Evey43 That's so disgusting of the doctor! Wanting to know what your reaults mean and where you stand is natural, obviously you would want to know what the results of tests mean for your health. It doesn't mean your angling for anything!

@Ginger89 I'm lead to believe pretty much all HSG's are painful regardless of whether there is a blockage or not - that's what my research (including on this forum) found. As you say, the main is only for a couple of minutes and worth it to know what's going on. There is a raised chance of getting pregnant in months proceeding a HSG (that's when I had my only natural pregnancy) so that's another reason to try and get one!

@Pinktruffle yes I felt it was as well. The NHS was pretty dismissive and I just didn’t feel listened to at all. I often left any appointments in tears with them telling me to give it time. We went in with the assumption if IVF was needed we would have to go private, but I know others that have had really simple reasons why they weren’t getting pregnant found via a blood test or something and easily sorted with medication. I also had no idea how to even start private IVF so was looking for information mainly. In addition if hubby does have an issue with his testicle we wanted that looked into regardless of fertility issues.

My GP said straight off the bat that they couldnt offer anything on the NHS. Any investigation would need to be done privately. I didnt argue too much tbh as I’m far too impatient for the waiting lists.

I have heard about painful HSG’s...! Given I will be mid cycle at my appointment on Saturday I doubt they will do it then. Will probably have to wait until next cycle

Just an update, I had an internal scan on the weekend. I was mid cycle and she saw an egg on my right ovary which had not been released yet. From my own experience/diagnosis I think I ovulate more out of my left ovary. I can usually feel exactly when it happens and come on my period 14 days after that.

I usually don't ovulate from the right side and although I have twinges, I wouldnt be able to pinpoint when the ovulation took place.

Hoping that if there is a problem its with the left ovary/tube and the right is fine - therefore increasing the chances for this month?

She is going to take some bloods cd 21 to see if I did ovulate. And I think will schedule in a HSG too. This is alongside a semen analysis for DH. Fingers crossed one of these things show what the issue is!

I ultimately lost both tubes to ruptured ectopics and was infertile within 3 years of my c section due to scar tissue and adhesions.

My HSG test showed my tubes were clear though so bear in mind they can give you false hope - they can only show you if the tubes are blocked or not. The test can't tell if they actually work

We moved onto IVF - 5 cycles, 4 transfers

Hi ladies

I'm in a very similar situation to you by the sounds of things. Conceived my LG within a few months of trying four years ago and had an emergency C-Sect.

We've been ttc for 2 years and Dr has just referred us to our NHS fertility clinic but DH wants us to look at private as the waiting time for NHS clinic is so long. I too have been upset by my Dr's attitude - I was told to relax, keep trying throughout the month. I just don't feel like it's being taken seriously and I'm terrified it has something to do with the C-Sect.

@Evey43 may I ask which clinic you're with to get things started so quickly?

I'm not sure whether all private clinics are operating more quickly than NHS ones?

@musicmaker89

If I'm honest I wouldn't bother with NHS testing - you aren't eligible for IVF on the NHS anyway as you already have a child. And they only do basic testing

I'm with Create and they reopened within days of the ban being lifted and I had my egg collection/transfer within 2 weeks. They have one of the smallest waiting lists as they only do short protocol mild IVF or natural modified IVF so whole process is over within 2 weeks - no weeks and weeks of down reg to go through x

@Evey43

Thanks for getting back to me. I know you're right about the NHS testing being a waste of time although I want to know if the secondary infertility has been caused by C-sect. Is it wrong of me to think that should be fixed on the NHS if it is? I have a gut feeling that is the problem as we conceived so quickly with our daughter. Still DH is eager for us to get a move on as he is older than me (43) and so I do worry for his sperm quality if we wait much longer.

I'm going to look into Create. We were looking at Care Nottingham but I see Create are in Manchester so we could travel to them.

It sounds like it's all happening really fast for you. Where are you up to in the cycle? Best of luck with it!

@musicmaker89

The problem is that there is no real way of knowing - even operating and having a good look in there they are only going to see scar tissue/adhesions

When I lost my first tube due to a ruptured ectopic they cleared out as much of the scar tissue and adhesions as they could and they said that my remaining tube looked clear, normal and healthy.....I campaigned heavily to get a HSG which isn't routine but should be after an ectopic and all that did is tell me that my tube was clear......I still went on to lose it after another ruptured ectopic. So there is absolutely no test or scan or operation they can give you which can tell you if your tubes are actually working and capable of moving an egg through it to the uterus

The NHS will also accept no liability for secondary infertility post c section - pretty sure the disclaimers we had to sign state they made us aware of the risk etc - I suppose the only fault of the NHS is not being more vocal that actually complications post c section are more common than we are led to believe. But I know loads of friends/family who had c sections and had no problems getting pregnant again

If the tubes are damaged there is also no way for the NHS to fix them

I lost my last tube last July which was ironically after an IVF transfer - I wasn't aware that IVF actually increases change of ectopics rather than decreasing it!

Since January last year I've done 5 egg collections, I had my 4th transfer last month and found out on Monday I'm pregnant with twins!! (I've previously had several miscarriages though so not getting my hopes up too much yet)

Not going to lie the cost is horrific we've spent £35k so far and this was our final cycle as we were ready to move on (I do have 2 more embryos frozen though). IVF is a big commitment - financially physically and emotionally and I feel guilty that my DD has suffered a lack of focus on her and had to deal with a hormonal mummy for so long

@musicmaker89

We’re with OXRM who do the blood tests, scans and sort out medication out and then link us up with another clinic to do the egg transfer and egg collection. We chose BCRM.

OXRM are very good and I’m really glad we just went ahead with private. I feel very looked after. As has been said you won’t be eligible for IVF on the NHS if you have a child even if you got referred to a fertility clinic. I didn’t want to wait months for an appointment just to be told I needed IVF and they can’t fund it. Even if you meet the criteria there’s a wait.

I think ours went ahead so quickly as we’d already done some initial tests on the NHS that were done via the GP (except AMH) and out clinic accepted the results and I had an up to date smear. The clinic did do a few extra bloods.

I get what your saying about finding out if the NHS is liable I guess but I imagine it’s all included when you consented to the c-section (likes there’s a choice really) and I can imagine that being a lengthy battle with no guarantee of the outcome you want. I am no expert though just my guess!

I would say booking an appointment with a initial private clinic just to talk about what you thinking/feeling/next steps is a good idea. Ours was about £100 and gave us so much more clarity

Xx

Hi all,

so sorry to hear about some of your experiences and thanks for sharing. My day 21 progesterone was 29.5 which my DR says indicates ovulation but she also did an ultrasound which showed the follicle at 4cm and still there on the ovary. She said this leads her to believe that I am producing eggs but not releasing them and that we should try a hCG shot next cycle.

She is reluctant to do a HSG at this stage but I think I am going to push for it. I dont want to do the shots for 2-3 cycles and then in the end find out it was the tubes all along

Do we think thats the right course of action?