Uterine damage after surgical procedure and IVF


We have just had our second failed cycle with icsi, we got to early blastocyst stage on both cycles,but unfortunately the embryos failed to implant!  13 years ago I had an abortion; could there be scar tissue preventing them to implant, and would you advise a hysteroscopy, or is it down to pot luck! We have had 4 cycles altogether but the first two cycles none fertilised, this was down to me not responding to the medication, they upped my doses and the last two cycles my eggs fertilised and we got more at egg collection! What would you suggest?

Thank you

Dear S.,

What I would suggest is what I always suggest on this website.  PLEASE make a diagnosis before going through IVF; get as much information as possible about the likely cause of your infertility.  Infertility is a symptom of something wrong, not a diagnosis. It is very depressing to keep repeating the obvious advice.  There is hardly any medical symptom (except in life threatening emergencies) where a doctor should undertake a treatment before attempting to make an accurate diagnosis first.  Doctors who persist in offering treatments for infertility without going into the background and causes of a couple’s infertility are, in my strongly held view, practising bad medicine.  Unfortunately, this is all too common, particularly in the private sector, but even the NHS is not doing a very good job in always ascertaining the basic cause of infertility first.

Of course you should have your uterine cavity assessed first.  But rather than a hysteroscopy which is more expensive and not quite as reliable, why not have a womb X-ray done by any competent radiological department in a general hospital?  This gives the maximum amount of information and done carefully can reveal a great deal of information, including any uterine damage or scarring after a previous surgical procedure.

Best wishes

Robert Winston