Q: I had a myomectomy done 4 years ago and had an incomplete abortion last year after a course of Clomid. My report read a single line enucleation of the fibroids in my womb. Do you think the embryo was unable to attach itself to the womb as a result of the residual mass? Can it attach itself to a surgery site on the residual mass? What is the best fertility treatment after myomectomy?

A:If you are unable to conceive (secondary infertility) after the last abortion, then you and your husband need to be investigated. As you have said that you conceived after treatment with clomid, I suppose you have an ovulatory dysfunction. Cause of abortion depends upon period of gestation that it occurred. Sometimes, an abortion can take place if implantation of the fertilised egg occurs at a scarred site, due to ineffective placentation. However, there is no way of predicting where the implantation will occur, nor any method to diagnose whether or not it has implanted on the scarred site.