Things I wish I'd known before trying to get pregnant after trachelectomy

Right, this is a list of things I wish I'd known a year ago.

1) If you don't menstruate in the cycle after cervical surgery, have the cervical opening checked - mine was blocked by a membranous overgrowth for 10 weeks, with menstrual blood backing up behind it.

2) Don't waste time trying on your own. Chances are there is more wrong with you than you realise. Consult a fertility specialist immediately.

3) Check your tubes. Almost a year after my trachelectomy and lymphadenectomy I've just discovered (via laparoscopic surgery) that my tubes were damaged and distorted, probably from the surgeon rooting after lymph nodes. A hysterosalpingogram (HSG), which is an X-ray of the uterus and fallopian tubes after injecting dye via the cervical opening is good.

4) Keep checking that the cervical opening stays open. After mine was initially opened up, it closed again after 6 months or so. Dilating it the second time was painful.

5) If you do artificial insemination or IVF, have your fertility specialist do a dummy run before D-day to make sure he knows where your cervical opening is and that he can get a catheter in there. If you're doing IVF, the dummy run must be guided with a sonogram to make sure that the catheter not only goes in, but that the embryo can be correctly placed.

6) Save your money. Fertility treatment costs more than you can believe.

Ho hum. In another year's time I'll probably have more to add...

By tam1
Posted August 14, 2009 at 12:51 pm
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moblis - can you perhaps go the surrogate route? maybe if you let up on the IVF, then one day it will happen out of the blue naturally. i know that seems like a long shot by now, but you never know right?

i was at washington hospital center last week getting a third opinion before a hysterectomy out of desperation (i'm in a similar situation as kat). i had to hunt down an atm machine to pay to get out of the parking garage. every other corner i turned, i saw a young, cute doctor. i'm like i need to marry one of them so i can pay for fertility treatments. or maybe one day they will come up with the artificial cervix idea. i mean they can sew a man's penis back on right.

your in my thoughts and i hope everything eventually works out for you.

By mobilis
Posted August 19, 2009 at 8:31 am
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Thanks Tam and Bar.

Bar, are you doing IUI or just timed natural cycles? It might be worth having your tubes checked out, they can do it with an HSG which doesn't involve any surgical procedure. We think that my tubes got mashed while the surgeon was removing the lymph nodes during the trach.

Tam, how did the third opinion go? I know you've been struggling for ages and ages.

I haven't tried IVF as such yet. I took advice from 2-3 fertility specialists, and all said that at my age I shouldn't waste time trying on my own because my chances aren't great after the trach. Now that one tube is open things might be looking up for us. I'm tempted to do an IVF cycle just in the hope that we might have some embryos to freeze - I think it would give me some peace of mind.

By GORKE
Posted August 19, 2009 at 9:31 am
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Mobilis,
Thank you so much for sharing this list...Its very helpful to me as I just had my trachelectomy done last week and my husband and I plan to try for a child in 6-9 months.....Best of luck to you and keep us posted!

By erinleigh8
Posted August 19, 2009 at 10:12 am
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Mobilis,
Thank you for this list. I will definitely keep all these things in mind in the future if I ever am at the point where I can try to conceive. Did you have the trachelectomy abdominally or laproscopically? How long ago was your surgery? Did you ask your doctor specifically to check that the cervical opening was still open? I haven't even thought to ask that because I just assumed that she's been checking. It's been almost one year since my surgery and I've had no problems yet!

Bar, I'm thinking of you always! Please let us know if there are any developments.

Tam, hope you hear something good from the third opinion.

Gorke, if you want to talk or have any questions post-trach, you can message me.

Erin

By mobilis
Posted August 19, 2009 at 12:31 pm
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Erin, I had an abdominal trachelectomy in September 2008. You will know if your cervical opening closes up, because it will eventually block your menstrual flow. I'm not sure if a laparoscopic/vaginal trachelectomy would cause less damage to the tubes - it's possible it could cause more, if the surgeon had less of a view when locating the lymph nodes.

Just to remind everyone that all my discussion threads are public, so if you want to share any personal or private information it's best to start a new thread.

By BAR32
Posted August 20, 2009 at 8:29 am
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Mobilis -- did the fertility specialist tell you that you would have a harder time ttc after the trach? (before learning of the tube issue?) Did they give you any reason for that, other than the lack of cervical fluid?

We have been doing timed natural cycles. I think we are about to move on to IUI.

By mobilis
Posted August 20, 2009 at 4:41 pm
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BAR, I'm attaching the exact words (cut and paste from an email) of the second opinion I received from another fertility specialist. The advice from both was exactly the same, I just don't have the first in writing.

"The issue with having had a trachelectomy from a fertility point of view is that the endocervical canal is destroyed/removed. This region is of extreme importance when it comes to natural conception. The mucus being produced in this area not only nurtures the ejaculated sperm, but also serves as a sperm reservoir, releasing sperm up into the genital tract at regular intervals. None of the “sperm friendly” preparations on the market can ever take over this function. Therefore, seeing that you are 35 years old as it is, I would encourage you to proceed directly to assisted reproduction and not waste any more time."

By PJ2
Posted August 21, 2009 at 12:29 pm
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I hear you!! I wish I had known much of that too after I was treated 10 years ago. I have gone through three boughts of cervical stenosis and now do not dilate at all, thus I have had several surgeries to repair the opening tomy uterus so I could have a period and get pregnant. Unfortunately, I will have togo through this agin, as I am pregnant and will need to have my cervix reopened after having the baby, even thought I will deliver via c-section. They just cut away at the cervix at the end of the c-section and remove the surrounding scar tissue and make it open again.

The things they never tell you that can happen. I was told that less than 5 percent of women end up with stenosis, but it seems more common than not.

Anyway, fertility and pregnancy after cervical surgery is something I try to educate women on, as the doctors never think to tell patients that there could be issues down the road. Like they remove your cervix and it is magically all better and you go back to normal, have normal pregnancies and conceive easily - yeah right!

PJ

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