Overview of Adhesions, Scarring and Blocked Fallopian Tubes

[fetch]

Hi Larry,

This may be tmi, but the delivery of my child included two sets of forceps and a plunger. Still, the baby was stuck facing backwards with the cord wrapped around his neck and heartrate dropping fast... so the OB on call "tore" me. It didn't help that my son has a large head. I had perineum tearing down through my sphincter.
It took a long time to close/heal. It was inflammed for a long time.
I could barely stand for long periods of time. Even after a year, some of the pain was still there. Sex was and still is painful, but my doctor says that's due to the external scarring from the stitches.

Previous to this and before my two laps, I had never been in a hospital, let alone had previous surgeries or falls.
This is what makes me believe that the adhesions were caused by this.
It's incredible and upsetting to think that my infertility could be caused by childbirth itself.

Originally Posted by lwurn

Hi fetch,

What tore during your delivery? If it was your vagina, that is below (and outside of) your uterus and cervix. You could have had severe tearing there that did not affect your uterus.

Your recovery was quite long, so was there an infection in your pelvis, or ongoing inflammation there? Those things can easily cause the fairly massive adhesion formation you describe. . . .

You are assuming that the internal adhesions were caused by the childbirth, but that is not necessarily true, is it? Other causes might include a traumatic fall onto your tailbone, hip or back, or surgery anywhere else below your waist. Any of those sound familiar?

larry

[jrzy1]

Originally Posted by fetch

Hi lwurn,
jrzy1 - Your daughter sounds like such a gift after everything you've been through. How scary all the things you've been through before, during and after your pregnancy. What an incredible story. Do you suffer from any pain? Are you doing IVF cycling right now for baby #2?

Yes, she truely is a gift and very treasured by my family. Especially when we walked into the first surgery not knowing if I was coming out with stage 4 ovarian cancer and a full hysterectomy to include my healthy baby. But we were lucky that it was totally benign.

I have on and off pain, mostly at my incision line. Its been cut twice in once spot and 3 times in the bottom half - when he did the c-section he cut along my scar (vertical) and then normal horizontal on my uterus. If I lift or do too much, I will get pain but thats probably due to my last surgery being just under 6 months ago.

Right now, I am doing a clomid challenge test. I took 100mg of that plus did bloodwork on CD3 and 10 to check my hormones to see if my ovary is still functioning. Just now doing OPKs to see if I will ovulate and then back to do CD21 bloodwork in a week. This test with the HSG will tell us if we need to do IVF or can try IUIs, if my ovary is still working that is

[jrzy1]

Thanks! Yeah, nothing normal happens with me. Its hard to stay positive and strong with all that has gone on this past year and a half. They were shocked that I was able to conceive with that cyst - by the time it was removed it was about 10 pounds - looked like a full term uterus. Must have been in there awhile, but never showed obvious symptoms

Originally Posted by lwurn

Hi Jrzy1,

O-mi-gosh! You really have had quite a time of it - really a complex surgical history, and yet still had a daughter. Your body/mind/spirit must be really strong to be able to conceive, naturally I gather, despite all you went through. Wow!

I can understand why your MD found so much scar tissue, after the several surgeries and healing events (blocked tubes, laparotomy, huge cyst, c-section). A lot of healing had to take place, and the first step in healing is the laying down of collagenous cross-links, the building blocks of adhesions.

Good luck with HSG, lady. The way your body is, hopefully you will get pregnant before!

lwurn

[lwurn (Board Sponsor)]

Ouch! That was terrible to undergo, and I am so sorry you had such an incredibly difficult experience. Unfortunately, adhesions are a major cause of secondary infertility, but they can be treated, and many women who experience secondary infertility go on to have more children.

Larry

Originally Posted by fetch

Hi Larry,

This may be tmi, but the delivery of my child included two sets of forceps and a plunger. Still, the baby was stuck facing backwards with the cord wrapped around his neck and heartrate dropping fast... so the OB on call "tore" me. It didn't help that my son has a large head. I had perineum tearing down through my sphincter.
It took a long time to close/heal. It was inflammed for a long time.
I could barely stand for long periods of time. Even after a year, some of the pain was still there. Sex was and still is painful, but my doctor says that's due to the external scarring from the stitches.

Previous to this and before my two laps, I had never been in a hospital, let alone had previous surgeries or falls.
This is what makes me believe that the adhesions were caused by this.
It's incredible and upsetting to think that my infertility could be caused by childbirth itself.

[TigerGirl]

Hey guys,

I just discovered this thread. Adhesions are one of my problems too. I had a ruptured appendix in 1993. It required major abdominal surgery because it had leaked into my abdominal cavity. I had no idea that in later years it would be one of the causes for my infertility. I had one blocked and one scarred tube. I had a lap done in 2006 and my doc lysed the adhesion he could. But I had a laporatomy in April 2008 for an endometrioma and there were more adhesions.

I am 42 so age is a major factor too. I wish I had known there was a possibility of a problem all those years though. I like to joke now that the poor sperm had to run an obstacle course through my reproductive system to get to the egg.

We've done one unsuccessful IVF and because of the age factor we are either going to try donor eggs or adopt. I plan to tell anyone I know who has had any kind of abdominal surgery that adhesions can form and affect their fertility.

Sorry this was so long.

Lisa

[fetch]

TigerGirl,

Isn't it incredible how most people don't know about adhesions??
I wish it was common knowledge.
I think about all those celebrities who opt to have c-sections for convenience. I bet they wouldn't be doing that if they knew. Then again, not everyone is prone to have them if I understand this correctly -- that they are absorbed by the body many times.

I hope your journey of donor egg or adoption comes soon for you. Good luck.

[verytired]

Hi -- This is a great topic. I have adhesions too, as well as fibroids and polyps. I've had numerous hysterocopies and myomectomies. My first surgery was to remove hydros on my blocked tubes -- and, my RE found lots of adhesions outside the uterus. When I had my next surgery for a fibroid, my RE again found tons of adhesions. I had another surgery for a fibroid -- and, my RE didn't find anything. However, I had yet another surgery -- this time for a polyp, and tons of adhesions were found again.

My question is -- do adhesions just keep growing back? Have I been misdiagnosed and actually have endo? Finally, I feel like my uterus is completely trashed now. I've had three early term miscarriages -- and, have moved onto a surro at my REs recommendation.

Sorry for this all about me post, but this issue has been gnawing at me. My surgeries were all done by different REs and unbelievably none of them look at my medical records from the other surgeries. In hindsight, I should have insisted on a review of these records and asked for opinions. But, seriously, I've been to the best clinics in the country, including CCRM. I blame my sad story on the egg centric view the IF world has. I have come to conclude my problem has always been in my uterus and not my eggs -- though, I did use DE and had less success with them than my own. (yes, it was a proven, young donor).

Anyway, any thoughts or opinions would be appreciated. Even though I'm done with cycling, the mystery is still weighing on me.

[Vancella]

My doctor has a blog and he wrote about tubal occlusion and adhesions this week:
http://www.100infertilityquestions.blogspot.com/

good luck to all of you.

[Vancella]

http://www.100infertilityquestions.blogspot.com/

[being ignored]

Hi, Lwurn,

I recently had a surgery because of ectopic pregnancy, and one of my tube was ruptured. If there is any adhesions, and if those adhesion can be removed, will it grow again in my body?

I came to this forum without any knowledge regarding adhesions and ectopic pregnancy.

90% is really scared me, but thanks for telling us.

If I could find this forum before, probably I can avoid what happened to me!

My husband and I were told by the doctor that we were very unlikely as unexplained infertility. We went through IVF cycle and unfortunately I had ectopic pregnancy, I kept on asking the clinic for my abnormal syptoms, but was ignored untill on Day 29 I went to emergency dept, then they found I had ectopic pregnancy, and a surgery followed...

Originally Posted by lwurn (Board Sponsor)

Hi fetch,

Welcome to this (brand new) forum. Adhesions are a very important aspect of urogenital and reproductive health.

It is reasonable to assume that the tearing at your 2005 traumatic delivery caused adhesions, as the body heals from such a trauma by laying down adhesions (scarring). Women who undergo that type of tearing also frequently develop painful intercourse from that event - generally be due to the adhesions, in our experience.

I don't think it is likely that your chemical pregnancy caused any adhesions. If you had a D&C afterwards, that could contribute to adhesions on your uterine wall, which might cause problems with secure attachment of a fertilized egg in the future, I believe.

The science I have read is pretty clear on post-surgical adhesions. For example, a 2001 study from the journal “Digestive Surgery” (author Liakakos) titled “Peritoneal Adhesions: Etiology, Pathophysiology, and Clinical Significance” addresses this.

The Results section of the study states this:

“Adhesions occur in more than 90% of the patients following major abdominal surgery and in 55-100% of the women undergoing pelvic surgery. Small-bowel obstruction, infertility, chronic abdominal and pelvic pain, and difficult reoperative surgery are the most common consequences of peritoneal adhesions. Despite elaborate efforts to develop effective strategies to reduce or prevent adhesions, their formation remains a frequent occurrence after abdominal surgery.”

If you want me to send you a link to the article, please email me and I will send it to you.