C-Section Scar and Fertility: Should Isthmocele Be Treated?

Written By Lora Shahine, MD

Did you have a C-section and now notice spotting that won’t quit? Are you dealing with pelvic pain, confusing symptoms, or trouble getting pregnant, and wondering if they’re connected? Has anyone ever mentioned the word isthmocele to you… or is this the first time you’re hearing it?

In this episode of Brave & Curious, Dr. Lora Shahine explains a condition many patients are never warned about after a C-section: an isthmocele. She tells us what an isthmocele is, how it can form in a prior C-section scar, and why it can sometimes lead to unexpected bleeding, pain, or fertility challenges. 

You’ll learn the five key symptoms that may signal an isthmocele, how this condition can affect fertility and future pregnancy plans, and the pros and cons of monitoring versus treating. Dr. Shahine also talks us through when surgical repair may be helpful, and the exact questions to ask your doctor so you can advocate for informed, personalized care. 

If you’ve had a C-section and feel like something isn’t quite right, this episode offers knowledge, reassurance, and a clear path forward.

In this episode you’ll hear:

[0:46] Understanding C-section scars: Isthnocele

[2:21] What is an isthmocele?

[3:24] How common?

[4:18] Getting diagnosed

[6:06] Symptoms

[7:36] Treatment options

[9:21] Observation vs. surgical management

[14:01] Important questions to ask your doctor

[14:57] Conclusion & final thoughts

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Lora Shahine, MD

Dr. Lora Shahine, reproductive endocrinologist at Pacific NW Fertility and Clinical Assistant Professor at the University of Washington in Seattle, completed her residency in OBGYN at the University of California in San Francisco and fellowship in reproductive endocrinology at Stanford University. She is dedicated to educating and advocating for increased awareness of infertility, miscarriage, and the impact on environmental toxins on health through an active social media presence, teaching, clinical research, and authoring multiple blogs and books including best selling, ‘Not Broken: An Approachable Guide to Miscarriage and Recurrent Pregnancy Loss.’

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