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Question
Posted by: Sash | 2004/11/23

TTC - laparoscopy, D&C, Fertomid

I have been tying for a year to fall pregnant and have one child, aged 2. Been for all the blood tests, scans and everything looks fine. For the past 6 months I have had breakthrough bleeding on day 7 of my cycle (brown blood); my periods lasts 2 days on a regular 28 day cycle and are quite light. Hardly experience any PMS and no pain or other discharge during my cycle. My gynae has suggested going on Fertomid to stimulate ovulation, even though the scan showed ovulation on day 12 (??). There is also the choice of going for a laparoscopy or D&C. I am confused by the choices presented to me and am not very keen on fertility treatment. If I have already had a child is it possible to then have blocked tubes? Also, is it possible for me to have endo or cysts/ PCOS even though I feel great and experience no pain/ heavy periods?

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Our expert says:
Expert ImageGynaeDoc

Your options are a) to wait and see. 80% of normal women fall pregnant within a year. You may just be one of those who takes a bit longer b) to embark on investigations to check if everything is normal. If you decide on the latter, a laparoscopy would be a good idea. Things could have changed in the past two years and endometriosis is a possibility even if you have no symptoms.

Best wishes

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2
Our users say:
Posted by: Sash | 2004/11/24

Thanks for the advice Golly. I did have a Caesar; alll the blood tests show hormones are fine and no thyroid problem. I have been to a homeopath who said my body was highly acidic and I have been taking tissue salts for that. I am at a loss.
I appreciate your response

Reply to Sash
Posted by: Golly | 2004/11/24

Sash,

If you had your first child by ceasarian section, there is always a chance of adhesions forming between the ovaries, tubes and abdominal cavity. These adhesions may constrict the tubes (opening or inside diameter) as well as the tube's movement towards the follicle during ovulation.

It is also possible that you have a slight hormonal imbalance resulting in a thin endometrium (which may be unable to sustain implantation) hence the light periods. Fertomid may interfere even more with the lining of the uterus and mucous formation to sustain the sperm. Possibly you have aneamia or thiroid or insulin problems - where these checked out yet? Another possibility is hostile cervical mucous which can be tested with a post-coital test.

D&C and laparoscopy are not fertility treatments but rather exploratory surgery (not very invasive) to determine if there are any physical obstructions, endometrioses or cysts present which may interfere with your fertility. You may be symptom-free but still have endo or cysts or adhesions.

If you do not feel comfortable with your options, I suggest you see a fertility specialist. They would be able to determine the cause of your fertility problems in a very systematic manner. Apparently secondary infertility (inability to conceive after a first child) is not that uncommon.
All the best!

Reply to Golly

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