Fertility & Pelvic Surgery

**Trigger warning: Discussion of fertility, sex and surgery**

Hello my lovely Pelican readers,

Recently, I ran a poll on my Instagram to address the following topic:

“Should post pelvic surgery fertility be spoken about more before surgery?”

Understandably, fertility in itself is a super important topic, before you even bring surgery into the equation. Before I start this blog post, I’d like to make it clear that there are plenty of people who go on to have children after pelvic surgery.

The results are in for my polls!

Q1: “Who thinks that fertility post pelvic surgery needs to be spoken about more & BEFORE surgery?”

Out of just over 200 people, 99% answered “yes” and 1% answered “no”.

Some people who voted “yes”  in this poll explained how doctors never brought up fertility before their surgery and in some instances, it was actually family or friends who mentioned it. Other people have said that although risks were briefly mentioned, they were not explained at all and others also commented that only when they started experiencing pelvic pain or problems/changes, fertility was then addressed.

My opinion and experience on this is definitely a “yes” answer. Fertility was actually only mentioned to me almost in general conversation with my team around 2 years post surgery almost as a bit of a throwaway comment, which I felt was very unprofessional and not patient centred at all. I felt like my fertility had been seen as insignificant, which is something you never want to feel, regardless of whether you want to have children or not. I couldn’t have avoided my surgery but it would have been nice to be educated on the potential risks and complications related to open pelvic surgery. It also wasn’t explained to me that surgery could affect my periods, which again only became apparent and discussed with me when it became an issue and I didn’t have periods for months, let alone regular ones. I only started having regular periods when I came off all forms of contraception barring using condoms after being on it several months post surgery.

My experience is unfortunately just one of many that have come from this poll and previous conversations that show a lack of care and acknowledgement we receive for fertility and pelvic surgery, let alone the fact a lot of us are not being given enough information so that we can make informed choices (where possible). It’s just not good enough.

Q2: “Has your surgery impacted your fertility at all?”

Out of just over 200 people, 58% answered “yes” and 42% answered “no.”

Comments that were left with regards to this question included that people were unsure, people didn’t know & hadn’t found any accessible ways of knowing unless they were struggling for a considerable time, others were told that they may not be able to carry children due to risks and some people commented that they’d experienced no issues & have healthy children regardless of the surgery.

In my experience, I have been unsure as we haven’t tried for children yet & I am still quite in the dark with regards to my fertility barring a home fertility test that Hertility Health kindly gifted me. They went through the results with me and thankfully they seemed good. This was the only time I’ve had some much-needed insight into such an important thing. Again, this highlights just how such an important topic is not getting the attention that it deserves, neither are the lives that it affects. 

Fertility impacts everyone, so why isn’t it something that is more central to patient care both before & after pelvic surgery?! I spoke to my current consultant about actually having children a few months ago & what my options would be with regards to the birth. His opinion on this was that nobody knows until my other half and I get to that point where we try & with regards to giving birth, some women who have had surgery give birth naturally whereas others have caesarean section and again, this would be something to discuss when the time comes. It makes me feel very uneasy that it’s all just in the air until it does or doesn’t happen, even though some things you can’t obviously know until you try.

As much as I understand that consultants can’t give me an in-depth answer, I do wish that I felt as if it was taken more seriously & that there were more things we could do such as tests etc without us having to wait to see if we could get pregnant & whether we had problems doing so. Something about it understandably doesn’t sit right with me, and many others too.

I have pelvic issues such as scar tissue that has matted my ovaries (the left more than the right as I look at me) and painful periods. Some of my reproductive organs have also tilted back and dropped round on themselves due to having my rectum & anus removed when I also had my colon & appendix out. Pelvic surgery also has risks for men, and it’s important to state that fertility is something just as important to men & that this post is considering fertility for everyone.

Scar tissue pain has been severe at times, but this seems to flare up when I am more sexually active & plays up for a few weeks at a time with increasing pain then fades away for a few months at a time & when I’m not as sexually active. Actually having sex isn’t a big pain thankfully, but occasionally certain positions can feel a bit uncomfortable, so it’s down to me to communicate this to my other half, who always makes me feel comfortable and is very understanding.

Pelvic issues and fertility are obviously not something that is the same for everyone. What issues you may have (if any) and to what extent obviously depends on your individual health & surgical circumstances. It is clear from my polls & the discussions I have had that fertility needs talking about more and sooner (where surgery isn’t an emergency).

What are your thoughts on this? Please feel free to head over to Instagram & message me or leave a comment on my related post (as seen below).

Please note that this blog post is intended to give advice to ostomates. The information given is based on Amy’s personal experience and should not be taken as clinical advice. Please consult with your Stoma Care Nurse if you are in need of medical advice regarding fertility and pelvic surgery.