Did any of you who had trouble getting pregnant use an at home ovulation kit? I was wondering if the trouble was with ovulation or blockage of the ovaries and fallopian tubes. We have been trying for four months without success. I already have two children pre-surgery and it didn't take that long either time. Maybe I am just being impatient.

For most j-pouch people it isn't that they don't ovulate, but that the egg and sperm can't meet due to scar tissue. So an ovulation predictor can help you determine if you do ovulate and when and might help in that sense. But if scar tissue is the issue it won't help much.

Don't forget, you are older this time around and the older you are, the more likely that your cycles aren't as predictible (specialists told me that there is a clear drop in fertility at 30 and another at 35 - don't know if you are in that range). That could be totally unrelated to the surgery. 4 months isn't that long but I would recommend having a fertility work up after 6 months if you haven't had luck. The usual waiting time is 1 year without a pregnancy, but given the surgical history, most drs will recommend 6 months so that you can determine if there is something that will truly impede things.

I tested fine (open tubes, regular ovulation, regular hormones), as did my husband but we tried 18 months with no luck. We ended up doing IVF which worked for us the first try both times we did fresh cycles; this proved that in our case, the issue was as I stated above, sperm and egg weren't meeting, probably due to scar tissue.

If your tubes were open where was the problem with scar tissue? And what kinds of test did they do to determine that your tubes were not blocked by scar tissue?

THe test is called an HSG test - they insert dye into the tubes with a catheter and then x-ray while it runs out. If the dye can make it through the tube and out, an egg can too. The test is a little uncomfortable, but done like any other outpatient x-ray (no sedation)

So, since my tubes were open, the issue was that there was scar tissue elsewhere in anatomy that was keeping the sperm from reaching the egg once it was released. That's the theory anyway. I got pregnant my first fresh IVF, then with a frozen embryo we transferred 18 months later (I miscarried that pregnancy) and then with our second fresh IVF cycle. So the issue isn't that I can't get pregnant. The issue was the sperm and egg meeting.

May I ask...if the tubes are not blocked then what causes the problems?? Is the egg not making it to the tube?

Fertilization does not happen in the tube (if it does, that is an ectopic pregnancy, not viable and potentially dangerous) - it happens after the egg is released from the tube. So my eggs can get out of the tube, but then have trouble finding the sperm (or the sperm have trouble finding the egg). What the drs think is that there is enough scar tissue in the general area that the sperm can't make it to where the egg is in time to fertilize.

By doing IVF the fertilization is done outside of the body and we know it works because we get an embryo. Then the embryo is transferred to the uterus and just has to find a wall of the uterus.

My situation is similar to Jill's. There were no identifiable reasons as to why I could not get pregnant naturally. The HSG showed that my tubes were clear etc.

My doctor however said that there might be scar tissue preventing the egg from reaching the tube after it is released from my ovary. The only way to really see if that is the case is to have a laparoscopy done. With my surgical history and potential mess in there, the doc said it would be too hard to see anything because of the scar tissue and it could be dangerous for the pouch due to the risk of perforation.

I am currently pregnant with twins from IVF and I asked the doc if I was to have a C-section would they be able to peek in there see if scar tissue was the culprit. The doc said absolutely.

Check out this website: http://library.med.utah.edu/kw/human_reprod/lectures/fertilization/

Fertilization can happen in the tube. The fertilized egg than travels down to the uterus where it implants. It would be an ectopic pregnancy if the fertilized egg would implant inside of the tube.

It took 5 months at 28 years old for me to get pregnant with my first and 20 months at 32 years old for my second.

Sunny days is right - it is implant in the tube that causes ectopic pregnancy...

Congrats on your twins Sunny Days! When are you due?

Hi Jill,

I am due 8-8-08. I am taking that as a lucky sign! I will probably deliver earlier than that though since it is twins. I am predicting July 11th. That would put me around 37 weeks but only time will tell.

Take care and good luck with your pregnancy as well!!

I have the same problem as sunnydays and Jill. Tubes are clear, nothing wrong with his swimmies, regular ovulation but egg and sperm can't meet.

We cannot afford IVF so we can't have kids.

Did any of you ladies have children before surgery that are now having problems? I am wondering if some fertility problems may have been there before. Just wondering! I had two children before my surgery and I am really wanting a third.

I was told by my GI (not my gyn mind you) that having the pouch surgery and having the pouch itself causes the potential for a decrease in fertility. I just had my pouch removed last month and he told me that having it removed can reverse any potential decrease I had had before. Not too sure how accurate that is. So I was under the impression that just having a pouch (not necessarily scar tissue) is part of the issue for j-pouch women.

I heard 2 conflicting things:

1. If fertility was affected, it was done so in the total colectomy step. J-pouch will not affect it.

2. Any time you undergo abdominal surgery, scar tissue can form and create fertility problems.


Love,