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Dr. Andrew Rynne

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Suggest treatment for difficulty in conceiving due to endometriosis Suggest treatment for difficulty in conceiving due to endometriosis

Answered by
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Dr. Timothy Raichle

OBGYN

Practicing since :1999

Answered : 1681 Questions

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Posted on Fri, 24 Mar 2017 in Birth Control
Question: please could you tell me what it means to have XXXXXXX run slow through both fallopian tubes. I had a diagnostic laparoscopy last Monday for on going pain and not being able to conceive since 2015. the findings were endometriosis a large piece of scar tissue from belly button to bowel area and also the XXXXXXX running through tubes slowly. please could you tell me what this means as I have no idea and there gynae has told my gp to refer me to surgeons and fertility clinic. what is this causing my tubes to go slowly why would I need to be reffered to fertility clinic Also what's the scar tissue from?
I must add I had a emergency c section in 2013 and get horrendous ovulation pain
doctor
Answered by Dr. Timothy Raichle 1 hour later
Brief Answer:
The scarring is from the C-section, tubes might be diseased

Detailed Answer:
Thank you for the question. So to summarize your situation:

1. You had a C-section in 2013 performed as an emergency
2. You now have a diagnosis of endometriosis and a tubal XXXXXXX study that showed that the tubes might be partially blocked.

First of all, endometriosis is a condition where the cells that normally cycle within the uterus get into the pelvis. These cells cycle and cause pelvic pain and in some cases can affect your ability to get pregnant. You had a laparoscopy for pelvic pain and they found endometriosis, all of which makes sense.

Second, they made a comment about scar tissue from the bowel to the belly button. Hopefully they fixed this, but this might described either a hernia at the belly button, or scar tissue related to the prior C-section. These are common findings in the setting of a prior C-section and probably not the cause of cyclic pelvic pain.

Finally, there was the comment that XXXXXXX did not readily spill from both tubes. Well, given that the XXXXXXX DID spill from the tubes means that they are open. It is possible, however, they they have been affected by endometriosis (which can cause some inflammation of the tubes) or the C-section (where they can be injured).

The reason that they are recommending that you go to a fertility clinic is because you have been trying to get pregnant for over a year, you have endometriosis (which is associated with not being able to get pregnant), and there is a concern that your tubes are not working normally.

Does this answer your questions?
Dr. Tim
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Timothy Raichle 23 minutes later
great stuff makes sense and I thought the scar tissue maybe from c section they didn't touch it they wasn't sure what is covering though it is near the bowel. the fact that I bleed from bottom on period and suffer with ibs symptoms agony gas pains and shooting pains up both ends does this indicate bowel endometriosis. sorry for all questions
doctor
Answered by Dr. Timothy Raichle 6 minutes later
Brief Answer:
Yes you can have endometriosis on the bowels

Detailed Answer:
Endometriosis can implant anywhere in the abdomen and I have certainly take care of women with bowel involvement.

With regard to the scar tissue, you need to ask them:
1. Was this a hernia at the belly button?
2. Could the location of the scar tissue be related to my IBS symptoms?
3. Do I need to see a General Surgeon to address this, especially if bowel is involved in the adhesions?

There really seem to be some loose ends and lack in communication going on. I would have you consider taking the operative reports and any pictures taken during the surgery and get a second opinion with another OB/GYN. The fertility clinic could also serve as the second opinion AND address the issues surrounding attempts at conception.

Dr. Tim
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Timothy Raichle 14 minutes later
I believe this is the case they have sent me back to gp telling them to refer me to surgeons and the fertility specialists. I think I should ask gp to refer me endo specialist at bsge centre do you think this is right ? can I ask the consultants secretary for my pics and report to get second opinion they basically did the lap showed me pics and told me info as I woke up and end of. thank you for your time
doctor
Answered by Dr. Timothy Raichle 6 minutes later
Brief Answer:
I think that the fertility clinic should be your next stop

Detailed Answer:
Because fertility doctors are OB/GYN's with advanced training, and the main goal is pregnancy (as I understand it from your questions), I think that they would be the most relevant next visit. I would do the following:

1. Get copies of all pictures taken during the surgery
2. Get copies of the operative report from the surgery
3. Get copies of any pathology obtained during the case
4. Schedule a consult with the fertility clinic
5. At that visit, you can address fertility, the bowel adhesions, pelvic and abdominal pain and the concerns regarding the fallopian tubes

This is how I would recommend proceeding.
Dr. Tim
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Timothy Raichle 14 minutes later
oh wow I never knew they could deal with all this. you know I'm in England right? would they be able to refer me to surgeons to get rid of that scar tissue it's huge. your right about conceiving. OK I'll get all my notes and get referred to fertility.
doctor
Answered by Dr. Timothy Raichle 1 hour later
Brief Answer:
Yes, I am able to see a general location identifier

Detailed Answer:
FYI.

A fertility specialist might review the films and still refer you to a general surgeon, but since the primary desired outcome is pregnancy, this seems like the best place to start first.

Dr. Tim
Above answer was peer-reviewed by : Dr. Arnab Banerjee
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