For many women, becoming a mother is one of the most exciting and rewarding moments of their lives. However, when faced with fertility problems, that dream can seem increasingly distant and difficult to achieve.

One of the most common causes of infertility in women is pelvic adhesions, also known as scar tissue. Pelvic adhesions can occur after abdominal or pelvic surgery, pelvic infection, endometriosis, or trauma to the pelvic area. These adhesions can affect a woman's ability to conceive and carry a successful pregnancy to term.

In this article, we will delve deep into what pelvic adhesions are and how they can affect fertility.

What are pelvic adhesions?

Pelvic adhesions are bands of scar tissue that form between the organs in the pelvis (ovaries, fallopian tubes, uterus, bladder, and intestines) and can cause them to stick together and lose their functionality.

Pelvic adhesions can affect fertility in several ways:

• The ovaries can adhere to other structures, damaging their ability to release eggs and hindering fertilization.
• They can cause damage or blockage of the fallopian tubes, preventing the passage of the egg from the ovary to the uterus and preventing sperm from meeting and fertilizing it.
• Pelvic adhesions within or around the fallopian tubes prevent the transfer of the fertilized egg to the uterus, thereby increasing the risk of ectopic pregnancy.
• Because pelvic adhesions can cause pain during or after sexual intercourse, many couples are forced to avoid having sex during the woman's most fertile period, which obviously hinders conception.

Main symptoms of pelvic adhesions

Most women with pelvic adhesions do not have symptoms, however, they can present as follows:

• Chronic pelvic pain
• Intestinal obstruction
• Painful menstruation
• Pain during sexual intercourse
• Infertility
• Increased incidence of ectopic pregnancies

Causes of pelvic adhesions

Adhesions are part of the natural process by which the body tries to repair itself after traumas caused by surgeries, infections, inflammatory processes, and endometriosis, among others.

Due to the possible formation of pelvic adhesions, any abdominal surgery can put fertility at risk and must be carried out with the utmost care.

Between 60% and 90% of women who have undergone major gynecological surgery develop pelvic adhesions.

Although all surgeries can lead to the formation of adhesions, it is more common after open surgeries than after microsurgeries such as laparoscopy.

The probability of adhesion formation after a surgical procedure depends on factors such as the type of surgery, the patient's medical history, and their predisposition to adhesion formation.

Some gynecological surgeries that can lead to the formation of pelvic adhesions are:

• Cesarean sections
• Ovarian cyst removal
• Uterine fibroid removal
• Tubal ligation reversal
• Surgical treatment of endometriosis

There are various techniques to reduce the formation of postoperative adhesions, so it is important that you and your doctor evaluate them before you decide to undergo gynecological surgery.

In addition to surgical procedures, other possible causes of pelvic adhesions are:

• Appendicitis
• Infections in the abdomen and pelvis
• Pelvic inflammatory disease (usually caused by sexually transmitted diseases such as chlamydia)
• Endometriosis
• Hydrosalpinx

How are pelvic adhesions diagnosed?

Pelvic adhesions can be difficult to diagnose.

Some reproductive health specialists consider that the only way to obtain a reliable diagnosis is through minor surgery called laparoscopy, which is usually performed under general anesthesia, carries risks for the patient, and can cause the formation of new adhesions.

However, at Ingenes, we recommend gynecological vaginal ultrasound, during which the doctor inserts a probe into the woman's vagina to examine her reproductive organs (uterus and ovaries).

This is a non-invasive method that generally allows for a clear diagnosis.

Nevertheless, in some cases, additional tests may be required, such as hysterosalpingography, a radiograph of the uterus and fallopian tubes, which the doctor can use to determine if there is any obstruction or other problems that prevent conception.

Because it requires the injection of a contrast medium through the cervix, this test can cause moderate discomfort, but nothing to worry about.

Treatments for achieving pregnancy when you have pelvic adhesions

While it is understandable to feel overwhelmed and discouraged at the prospect of facing pelvic adhesions, it is important to know that there are treatment options available. By talking to your doctor and seeking help from fertility specialists, many women have overcome difficulties and fulfilled their dream of becoming mothers.

When seeking to achieve pregnancy, in vitro fertilization (IVF) is the treatment of choice because while pelvic adhesions often alter the transport of gametes (eggs and sperm) and obstruct the transfer of the fertilized egg to the uterus, it makes it possible to aspirate the eggs directly from the ovaries, fertilize them in a laboratory, and place the embryos with greater implantation power in the uterine cavity.

This makes the fallopian tubes no longer essential and offers a higher probability of pregnancy than any other available treatment.

I have pelvic adhesions and want to be a mother

If you have pelvic adhesions and have not been able to become pregnant, do not hesitate to seek help from experts, come to Ingenes!