C section impact on future FETs / second IVF pregnancies

[GracePKI]

I’m currently pregnant following IVF and trying to decide whether to have an elective c section or a natural birth. For various reasons, I had almost fully decided on c section but in my doctor’s appointment yesterday they flagged that the c section scar can impede implantation for future IVF transfers (and the recommended wait time between births is longer for this reason not just the usual risks of rupture etc once actually pregnant). This is specific to IVF because of how they transfer the embryo and doesn’t affect natural pregnancies.

I feel like getting pregnant this time was a miracle and I don’t want to assume we would be as lucky again, but we have 4 frozen embryos from various cycles and I don’t want to reduce prospects for those by choosing a c section (if I don’t end up needing one for medical reasons).

Anyone here had successful transfer in IVF relatively soon (eg a year or less) after a C section?

Ideally of course we would wait a couple of years but time is not on our side (lining seems to require stims to thicken beyond 7mm - and hence a decent number of follicles, which just gets lower the older I get).

Any positive experiences, thoughts or tips from those who have been in similar situations would be appreciated!

You don't need to worry about timing now you've got your embryos, they can give you estrogen and progesterone to encourage lining, also vitamin E helps. I would go with the elective C-section, the state of the maternity care in this country is terrible, it's most important that you and this baby make it through the birth alive and with no permanent damage

@ButterscotchBabe definitley agree about the state of maternity care! Unfortunately for me despite having embryos I have had huge trouble in getting my lining thick enough for transfer (including estrogen and lots of other meds in FET cycles - have had numerous FETs cancelled). So timing is an issue - because I need to do stims for my lining - that’s why I was hoping for stories of those you have had a section then gone on to have successful transfers soon(ish) afterwards.

@GracePKI ah I see, hopefully someone will be able to give you that reassurance 🙂

@ButterscotchBabe thanks ❤️

Second ivf pregnancy here. Personally would not go for a c section unless medically necessary, but that’s just my personal view on the over-use of c sections and birth interventions more generally. I do think you need to focus on this pregnancy that exists, rather than hypothetical future pregnancies, and if you had decided on a c section for whatever reasons and you were happy with that choice then perhaps just stick with that choice? 🤷‍♀️

@2mumlife thanks for the reply & that’s exactly what my partner has said too! I’m a control freak though and need to know all the variables before I come to a decision - so this really threw me yesterday, as I wasn’t aware it was a risk factor! Have you had a c section?

I’d check with your clinic what their hypothetical view is. I had an emergency caesarean at the end of last year and my consultant is happy for me to have a frozen transfer once my daughter turns one whereas the obstetrician who discharged me from the postnatal ward recommended waiting three years to try again!

@CharlotteYorkMacDougal three years seems excessive! Thanks yes I also plan to speak to my clinic to get their thoughts x

I have an emergency C section in my first birth and did IVF 3 years later. They just checked that there was no scarring and embryo was transferred far from the scar. I don’t think it’s a massive issue just a consideration. Although I would be more worried about having a baby just a year after C section which has greater risk for uterine rupture, better to wait 18 months.

At the end of the day it’s your choice and you decide what’s best. There is a risk in all birth options and don’t be pressured by the natural birth movement, natural birth is great but not everyone is going to be able to go down that route.

Hi @GracePKI . I've never wanted a c section, but sadly with our daughter I required an emergency c section after getting to 9cm. I was gutted! There was a complication due to her positioning causing them to extend the cut in my womb. I was told to not get pregnant for at least a year as the risk of rupture in a subsequent pregnancy would be increased if the scar was not given enough time to heal. The risk is still increased even with substantial healing time, which is a scary thought. I was also told about the future risk of ectopic pregnancy occurring in the scar, which would have not been the case if I could have avoided the c section, but the risk to us both was too much to avoid the procedure sadly. I've had my first ever fresh embryo transfer one year on from the c section and I'm 5+2 weeks pregnant now, so hopefully all is well and we can go for a natural birth this time round! I am aware though I will be monitored like a hawk and at the slightest suggestion of a rupture, I'll be took for an emergency c section again.

Hi @GracePKI and congratulations!

Like @Zeeha I had an emergency C-section with my first IVF baby and was told to wait one full year before trying again.

Eventually it was a bit longer for us and we had a failed transfer 1y9m later and a successful transfer 1y11m after the C-section, but I'm 24w and nobody has mentioned avoiding a vaginal birth or uterine rupture or anything like that (yet!).

I was quite worried about scar adhesions and so on though so, although no judgement at all about an elective C-section, it can definitely bring about extra worries when trying again.

Thanks all - really good to hear your experiences of successful transfers after c sections! And congrats @Zeeha and @beachbum85 hope your pregnancies go well ❤️

Just to add that my understanding is that there’s no increased risk (when first birth was c section) of uterine rupture with an IVF pregnancy than natural - its implantation that can be affected.

Hi had booked an elective c section due to extreme anxiety after a miscarriage,age,ivf pregnancy etc but baby girl decided to come 3 days ahead of planned section date.Ended up being an emergency section as I was in full on labour within an hour of waters breaking.I did get pregnant naturally 8 months later so no issues with implantation.That pregnancy did not work out but recently had an internal scan before starting ivf and consultant said no scarring from c-section or D&C present.Not the same I know but our ivf clinic would not let us go for another ivf cycle until a year after the birth of our daughter due to c-section.x

I've had two successful IVF pregnancies and two non-elective c-sections due to previous surgery. I didn't have any trouble either time as they were my first and second transfers. My doctor did want me to wait a year been birth and second transfer. I'm just one case though and the doctors will be advising based on research across many people.

My doctor did tell me after my second section that they would only recommend max 3 c-sections

Thanks @Firefly42 and @CycleGirl20 very helpful and reassuring!

@GracePKI No experience of c section sorry, I had a forceps delivery after spontaneous labour

Also just to say it’s recommended to wait 12-18 months after birth before conceiving again regardless of how you gave birth, just to give your body time to recover, including things like replenishing iron stores etc etc

I haven't had a C Section yet, but it's coming soon. Both my IVF specialist and OB are not worried about having a C section. They just wanted I wait 6 months after birth to have another FET.

My Fertility Specialist adds Neupogen a couple of times before transfer to help with the lining.

I struggled so much for years to get this far on a pregnancy and due to my health issues baby would have to come earlier, that I would never go for a natural labour. My OB agrees that that's the best way for me and doesn't think that it will interfere with future IVF transfers.

If your heart is set on a C Section, just go ahead and have it.

@2mumlife thanks for the reply! Yes I’d be looking at around 12 months for an FET all being well. Just not sure I could get away with waiting longer given lining thickness issues for me seemingly being dependent on no. of follicles.

@Olivie12 really helpful, thanks! I haven’t used Neupogen before (feel like I must have had everything else 😂) - so will bear that in mind / ask my clinic about it! Congrats on your pregnancy, and very best of luck for the c section & baby’s arrival ❤️

I had an emergency c-section three years ago and now pregnant from my second IVF round. No one mentioned the scar being an issue and for me it clearly hasn’t impacted implantation! I plan to have an elective C-section with this baby, but it’ll be my last.

Congrats @AnnieStar12 & best of luck!

I had a planned C-section almost 2 years ago.
My consultant in the hospital advised to wait 9 months before TTC but in any case my clinic don’t transfer until a year post C-section. I’ve had 2 failed FETs and after the last one they have mentioned a potential issue with the scar tissue and want a hysteroscopy before I transfer again.
I chose C-section as after many years of treatment I just wanted my baby out safely and was convinced I would end up with one anyway so preferred it to be planned. It’s a shame if it has now been the cause of the subsequent failed transfers but there could have been other factors at play.

@GracePKI You never know, you might get lucky! We did a FET when DD was 16 months, and it worked first time 🙌

@finiteelement I’m so sorry about the failed FETs (I have been there - one ectopic, one BFN and one chemical). I hope the hysteroscopy gives you some answers and if it is scarring related that they can address it in some way ❤️

Is a hysteroscopy the only way to know if you have a C Section scar? Would it come up on ultrasounds or MRI?

Asking because I have a C section planned soon and will do another FET next year.

I also went through lots of treatments and D & C's before this so I prefer a C section. Although baby has been breech for a couple of months so would have needed the C section anyway.