Fluid in uterus

[shaniahoo]

I had an ultrasound today which was the start of some fertility tests after trying for a second child for over a year. Apparently I'm due to release 2 eggs this month, which is cool! The sonographer said though that I have a bit of fluid in my uterus. She said fluid can cause problems with implantation but that it might just be a transient thing that will go away and isn't a long term problem. And it might be from the niche in my c-section scar. I have several days before we have the consultant's appointment where we can discuss all my results, so I feel a little bit lost with this knowledge. She seemed to make out like it wasn't a big concern, but then I'm googling and it sounds like if you have a c section niche then that will mean you have fluid in your uterus all the time and it's a difficult and expensive problem to fix. I just feel a little bit confused and lost and like this means I can't ever have another baby. Has anybody here had a problem like this?

Hello. Just after some advice if anyone has had a previous c section scar defect (niche) repaired via laparoscopy? Since TTC my second child (started IVF again in August last year) I’ve had a miscarriage (untested embryo) and two failed transfers (these were euploid embryos). I have a niche and my consultant thinks it may be an issue but then cannot be certain. Have fluid collect in the niche in first half of cycle but usually disappears when starts progesterone but I know it can cause other issues like inflammation. I’ve done so much reading of medical studies and there’s no conclusive results as to whether surgery helps implantation but I think I will have it done as I don’t know why else the embryos are failing. Will do EMMA/ALICE test too just if anything to rule things out. I’m led to believe that ERA might not be relevant in my case as I’ve had two IVF pregnancies (one live birth) on the standard window of implantation but then ERA can change if you’ve had a miscarriage? Anyone have any experience of this surgery and did it help? I’m scared to be honest. I’ve been told recovery before next FET will be about 3 months. I’m in London. Thank you so much x

Hi @Aftertherain1 I’m sorry to hear about your miscarriage and failed transfers. I’ve been in a similar situation. We were lucky enough to have our son through my very first transfer, he was born in May 2021. We started IVF again the following April (2022) and I’ve had a CP, followed by a laparoscopy to remove a hydrosalpinx, followed by 3 failed transfers. There has been varying amounts of fluid reported on almost every lining scan I’ve had (I think mine is brought on by the estrogen too as it’s never there on the baseline scans), and I was advised in May by a sonographer to have my c section scar looked at.

I went to see Mr Adrian Lower privately and I would highly recommend him. I found his name on Mumsnet as he’s one of the UK experts when it comes to niche repair. He scanned me and said my niche wasn’t wide enough to warrant repairing and he would only be worried about fluid if it carried infection, so advised me to have the Emma/Alice/Era with a mock cycle. I did that in July and the biopsy came back showing no inflammation or infection, the ERA just showed I was pre receptive and needed an extra day of progesterone. Like you, I’m not completely convinced about the ERA, but I’m about to have another FET next week and we’re going to make the change and see what happens.
I was really worried about my c section and a possible niche but he really put my mind at rest and when he said it didn’t need repairing, I felt I could trust his opinion. He scanned me on another two occasions in the run up to the biopsy and on one of those occasions the fluid had disappeared despite taking estrogen. He has a private practice on Upper Wimpole Street so if you’re in London, it would be ideal.
Wishing you all the best, I know how you feel, it’s very frustrating when you’ve had success initially x

Thank you so much for replying. We are in similar situations. I have seen Dr Navekar, a consultant who works alongside Kings fertility and has experience in this area. When we spoke about surgery (before my last FET) he was very non committal about the impact it might have on implantation and said it was my decision. We decided to go ahead with the FET in August and it failed. We are just about to start another fresh cycle (to freeze if we get any embryos for PGTA) and I was thinking of having the surgery after this (so late October) then doing a mock transfer for ERA/EMMA/ALICE in maybe December then a FET in likely Feb (we have one remaining embryo from a prenups cycle) but now I’m wondering if I’m jumping the gun with doing the surgery first. My niche is narrow and I think about 5mm long with good muscle tone around. Doo ok you know the size of yours? It’s really interesting to hear that Mr Lower said yours wasn’t a concern due to size. I’ve heard he’s one of the best in this field.
The thing that niggles me is that on both previous FETs I’ve started bleeding 5dp5dt and the FET in August we added extra progesterone in so unlikely that so I feel that something is wrong in my uterus. Because I got pregnant with the niche I know it’s possible. I was always led to believe that as I got pregnant (my little boy) with IVF on the 120 hour (5 day) progesterone window that it wouldn’t change but then I read something about a miscarriage can alter this. So confused! After reading your post it’s given me some things to think about and maybe I’ll do the ERA etc first.
I wish you all the best with your transfer, thank you so much for replying to me x

Hi @Aftertherain1 Thank you too, it helps to speak to someone in the same position. No worries at all, I know how difficult it is when there don’t seem to be any firm answers. I’ve had a look back at some scan reports and my niche is 6mm by 2mm. It was the 2mm measurement that Mr Lower said was too narrow to warrant repair.
Like you say, we’ve both achieved implantation with the niche so that seems a positive thing too.
It’s so hard to reconcile the numbers game theory against wondering whether something is wrong inside!
That’s interesting that miscarriage could affect the progesterone window, I hadn’t heard that, but I suppose that could apply to me too. I asked Mr Lower how it had worked with my son if I needed an extra day and he more or less said it wasn’t an exact science and maybe he had slipped through despite that (I’m paraphrasing!).
We’re with a new clinic now in Barcelona (we’re having IVF abroad) so we’ll see what happens. I’m starting Lubion at the same time as the pessaries this time too, so I’m hoping that might make a difference as well.
I’m also taking 6mg of progynova vs 8mg so I’m hoping that might mean less fluid! My lining has thickened up enough with the smaller dose so I’m pleased about that, at least. Small wins!
Wishing you all the best too, keep in touch x