D&C and fertility?

chelseabare · 10-01-2009, 12:55 PM

Ok, As you guys probably recognize by now, Ive been asking a lot of questions... LOL... But my OB had suggested a D&C but told me that I wouldnt be able to get pregnant if I did that, and then one of the ladies on the board asked me if I had considered it, and just made it seem as though I could still get pregnant if I had a D&C? The story is I have a thickened Endo at 22mm with a history of polyps. Provera didnt change the thickness. Biopsy showed no cancer. I have had 2 'probable chemical pregnancies' as my ob said, and have been referred to an RE. My appt. is Monday. Can anyone explain this D&C to me. I realize that your endometrium is completely scraped out.... I thought that meant it wouldnt come back.... ? Does it?

Clarity please?!

Acajou73 · 10-01-2009, 01:02 PM

I had a D&C due to a missed miscarriage. They basically dialate your cervix and gently scrape out the endometrium. There are certain risks. Asherman's syndrome (i think that is what it is called) that causes the uterus to get stuck together because of overzealous scraping.

It obviously didn't affect my fertility. I'm 30 weeks 1 day pregnant.

I did get pregnant imediately after my D&C (it was for my first pregnacny), but miscarried that one and the pregnancy that I had immediately after that miscarriage. But, they were due to a clotting disorder and not the D&C.

A D&C is like having your period. In fact, my doctor told me that it is considered day 1 of your period. I was also told that I could ovulate 2 weeks later and possibly get pregnant again before my actual period came. I did on both counts.

So, the endometrium does grow back. When I said it was like your period, I mean that it sheds each month if there is no pregnancy.

chelseabare · 10-01-2009, 01:11 PM

Ok, so I wonder what my ob/gyn meant by saying I wouldnt be able to get pregnant?? Thank you though! That makes sense.... Endo sheds with period, D&C jsut makes it shed.... Got it. Thanks!

Eumie · 10-01-2009, 01:46 PM

Are you sure she was talking about a D&C? My doctor and I talked about me having an endometrial ablation after I'm done with the babymakin' which would make me unable to have a child.

chelseabare · 10-01-2009, 01:53 PM

well hmmm.... I remember her using the word D&C, but maybe she said it was like a D&C....? Is the ablasion similar to a D&C? Cuz she explained that she would go in and remove the endometrium by scraping it out, but I wouldnt be able to get pregnant if I did that.... It is SO possible that I couldve miss understood her though. I have been known to do so before many of times in many situations.... LOL

Samie · 10-01-2009, 02:05 PM

Maybe she was saying you wouldn't be able to get pregnant before the D&C? ???
I have no idea, I was actually under the impression that with some women, having a D&C improves chance for pregnancy/implantation.

cboytitan · 10-01-2009, 02:13 PM

It is a fairly common procedure when women miscarry. A friend of mine ended up having to have 2 of them during her miscarriage; and she's 34ish weeks pregnant right now.

I would definitely ask what the OBGYN meant.

Acajou73 · 10-01-2009, 02:34 PM

Endometrial ablation

Endometrial ablation is a procedure that uses a lighted viewing instrument (hysteroscope) and other instruments to destroy (ablate) the uterine lining, or endometrium. Endometrial ablation can be done by:

* Laser beam (laser thermal ablation).
* Heat (thermal ablation), using:
o Radiofrequency.
o A balloon filled with saline solution that has been heated to 85C (thermal balloon ablation).
o Normal saline (heated free fluid).
* Electricity, using a resectoscope with a loop or rolling ball electrode.
* Freezing.
* Microwave.

The endometrium heals by scarring, which usually reduces or prevents uterine bleeding.
What To Expect After Surgery

Endometrial ablation is usually done in an outpatient facility or hospital. The procedure may be done using a local or spinal anesthesia, although general anesthesia is sometimes used.

It takes a few days to 2 weeks to recover.
Why It Is Done

Endometrial ablation is used to control heavy, prolonged vaginal bleeding when:

* Bleeding has not responded to other treatments.
* Childbearing is completed.
* You prefer not to have a hysterectomy to control bleeding.
* Other medical problems prevent a hysterectomy.

How Well It Works

Most women will have reduced menstrual flow following endometrial ablation, and up to half will stop having periods. 1

Younger women are less likely than older women to respond to endometrial ablation. After an endometrial ablation, younger women are more likely to continue to have periods and need a repeat procedure.

Young women may be treated with either gonadotropin-releasing hormone analogues ( GnRH-As) 1 to 3 months before the procedure. This will decrease their production of estrogen and help thin the lining of the uterus (endometrium).
Risks

Problems that can happen during endometrial ablation include:

* Accidental puncture (perforation) of the uterus.
* Burns (thermal injury) to the uterus or the surface of the bowel.
* Buildup of fluid in the lungs (pulmonary edema).
* Sudden blockage of arterial blood flow within the lung (pulmonary embolism).
* Tearing of the opening of the uterus (cervical laceration).

These problems are uncommon but can be severe.
What To Think About

Regrowth of the endometrium may occur after you have endometrial ablation. This procedure is not recommended if you have a high risk for endometrial cancer.

Do not consider this procedure if you plan to become pregnant in the future.

Although this surgery usually causes sterility by destroying the lining of the uterus, pregnancy may still be possible if a small part of the endometrium is left in place. This can lead to severe pregnancy problems. Birth control of some form is needed if you have not finished menopause.

Quote:

Originally Posted by chelseabare
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well hmmm.... I remember her using the word D&C, but maybe she said it was like a D&C....? Is the ablasion similar to a D&C? Cuz she explained that she would go in and remove the endometrium by scraping it out, but I wouldnt be able to get pregnant if I did that.... It is SO possible that I couldve miss understood her though. I have been known to do so before many of times in many situations.... LOL

mixedupmarie · 10-01-2009, 03:01 PM

I've had a D&C due to endometrial issues, I had constant bleeding and provera wasn't helping. My dr did the D&C and placed me on birth control for a little while. When I was ready to try to get pregnant. My cycle regulated after a about 4 or 5 months and then I got my BFP and it's sticking. I'm not sure why the dr would tell you wouldn't be able to have kids after a D&C. I know they don't always recommend getting pregnant right away. But a D&C will definitely help your endometrial issues. Good luck.

HRkswildcat · 10-01-2009, 05:22 PM

Maybe your doctor said you shouldn't get pregnant right away after the D&C and you misunderstood?

Do you have this appt. booked yet? You could always call the office and tell them you would like some more information about the procedure.
I suggest writing stuff down during the appt. I always try to do this because things can go so fast during the appointment that sometimes you can forget what was said.

Leigh74 · 10-01-2009, 05:23 PM

Chelseabare - You and I seem to have the same questions...you always beat me to posting questions
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Seems like we are at the same place cycle wise and have the same issue with the thickening of the lining.

I have to go for a repeat ultrasound next week once this AF or whatever it is finally ends. I am going to ask what the thickness is considering you were given that info. I couldn't take Provera due to a family history of strokes and blood clots. A D&C was mentioned by my doctor if this ultrasound still shows thickening.

I was going to ask about the connection between thickening of the lining and pregnancy not sticking...but I think I got my answer from this thread
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I should have gotten pregnant no questions asked this month and I am totally pissed that it didn't work!! I am convinced that the thickness is why it didn't work. I can't wait to get my repeat ultrasound done!!

To think I was only getting the ultrasound done because of pain sometimes during sex and I questioned cysts...only to find out that I have no cysts but thickening. I am not ttc but this would hold me back if I decided ttc. There are also negatives to having the thickness so I am glad to have had the ultrasound!!

Keep posting if you find out more info on D&C's or the lining issue.

duramater · 10-01-2009, 05:45 PM

I've always heard a D&C was good for improving lining and getting you pregnant. I used to volunteer at Planned Parenthood, and following surgical abortions we always strongly caution women not to have sex for the next two weeks - not at all, even with condoms and bcp - because they are highly likely to get pregnant again.

Acajou73 · 10-01-2009, 06:13 PM

Here's what I found about a thick lining

"In general, 8-13 mm is good, less than 6 is potentially a problem, and greater than 15 or so could possibly reduce chances for a successful pregnancy."

When I had my D&C, they never told me not to prevent, just told me that I could become pregnant. But, since they were convinced that my pregnancies were just flukes, they didn't think i'd get pregnant again.

Are any of you ladies on met?

noelswifey · 10-01-2009, 07:27 PM

I have been told by a couple of doctors that having a D&C makes you very fertile after. I am actually thinkong of asking my doctor to do one on me if this next cycle doesnt work or i dont not get my period soon.......I hope everything works out for you

chelseabare · 10-01-2009, 11:30 PM

Wow, I definitely misunderstood my dr then. Just to clarify for everyone I am NOT scheduled for one. It was an option given to me by my ob/gyn. I just may go for it if my RE gives the same advice.

Seriously, you ladies never fail me. Yall ROCK!!