Red Light Therapy for Secondary Infertility After Cesarean
Understanding Cesarean Scar Defects and Adhesions
If you're trying to get pregnant again after a cesarean and something just feels off - you're probably not imagining it. If you’re not TTCing but want to help minimize these adhesions which can attach to other organs (especially if they are causing you pain). I’m working on another article on this topic - coming soon.
Many women experience what’s called secondary infertility after having a C-section. It often shows up as delayed conception, spotting between periods, implantation issues or feeling like your body just isn’t syncing the way it used to. But the real cause is rarely talked about (especially for women considering their options for the next birth - VBAC or cesarean). The more cesareans a woman experiences the more risk of developing adhesions and niche issues.
Two major culprits are cesarean scar defects, known as niches, and internal scar tissue called adhesions. Both can quietly interfere with fertility, and most women never hear about them until much later.
What is a niche and why does it matter?
A niche - also known as an isthmocele - is a small pouch-like defect in the uterine wall at the site of a previous cesarean incision. It’s more common than you might think. Studies show that up to 70 percent of women develop a niche after a cesarean when assessed with ultrasound or MRI (Bij de Vaate et al., 2011).
This tiny indentation may trap old blood and cervical mucus, disrupt sperm transport, and interfere with embryo implantation. It can also cause irregular spotting, postmenstrual bleeding, and lower abdominal cramping, even when everything else appears "normal" on a standard fertility workup.
For women with a niche and unexplained secondary infertility, IVF success rates can be lower compared to women without this scar defect (Tower & Frishman, 2013). That’s why it’s so important to identify and address it early.
Adhesions after a cesarean
What about adhesions?
Adhesions are bands of internal scar tissue that form after abdominal surgery, infection, or inflammation. After a cesarean, adhesions may develop between the uterus and surrounding organs like the bladder or abdominal wall. They can also affect the ovaries or fallopian tubes.
Here’s the problem, there may be no signs that you have them. But they can physically restrict movement of the reproductive organs, prevent the egg from reaching the fallopian tube, or impair ovulation altogether. In some cases, they also distort the uterine shape or create chronic inflammation.
Research has shown that pelvic adhesions can be found in over 40 percent of women with secondary infertility, especially after surgical births (Tulandi et al., 2009). They’re often missed unless a laparoscopy is done.
Can red light therapy help?
Photobiomodulation (PBM), also known as red and near-infrared light therapy, is a non-invasive, drug-free approach that’s gaining momentum in fertility care, especially for post-cesarean healing.
Here’s how red light therapy may reduce these issues.
PBM helps stimulate tissue repair and collagen remodeling in areas that have been damaged or scarred, including the uterus and pelvic region. It increases microcirculation and reduces oxidative stress, which supports healing of both niches and adhesions.
Studies show that PBM enhances the activity of fibroblasts and stem cells, which are essential for proper scar remodeling. It also helps reduce chronic inflammation - something both niches and adhesions have in common.
PBM can also be used to stimulate the sacral nerves and brain regions linked to reproductive hormone regulation, making it a powerful tool for rebalancing the entire reproductive system after surgery (but we don’t have studies on this specific issue - yet).
Skin contact matters - too much light bounces off red light panels.
What are my next steps?
If you’ve had a cesarean and are struggling to conceive again, it’s worth exploring whether a niche or adhesions might be part of the picture.
Ask your provider about tests to check for a niche. If adhesions are suspected, imaging or laparoscopic surgery may be needed for diagnosis.
Before jumping to surgery, consider starting with photobiomodulation therapy. It’s non-invasive, has no downtime, and addresses both uterine healing and whole-body hormone balance (based on what we know about how red light therapy works).
Other treatment options may include hysteroscopy to resect a niche, laparoscopic surgery to remove adhesions, or hormonal suppression in some cases. But PBM can be a first-line option that improves healing naturally, especially when combined with personalized nutrition, movement, and mind-body strategies.
My cesareans were years ago - will red light therapy still help?
Again, we don’t have research in this specific area but many other studies that demonstrate that PBM is likely to help.
Red light therapy sends specific wavelengths of red and near-infrared light deep into your tissue. This light recharges the mitochondria - the little engines inside your cells, so they can get to work repairing and rebuilding. When your cells have more energy, they start to do what they’re designed to do: heal.
Next, it calms inflammation.
Scar tissue isn’t just stiff, it’s often inflamed, especially if it’s been around a while. PBM helps bring overactive cells back into balance, easing that low-grade swelling and irritation that can make old surgical sites feel tight, painful, or just “not quite right.”
Then, it boosts circulation.
Think of it like turning on a bunch of tiny faucets in the area. With better blood flow comes more oxygen, more nutrients, and more support for healing. This can help loosen dense scar tissue and improve how the area feels and functions.
And most importantly, it helps your body remodel that scar tissue.
PBM encourages your body to gradually soften and break down old adhesions, making tissue more flexible and less restrictive over time. For reproductive health, that means the uterus, ovaries, and surrounding structures can function the way they’re meant to.
Now here’s the best part: this still works even if your surgery was years ago.
Your cells never stop responding to the right signals, and light is one of those signals. PBM reduces the inflammatory messengers that keep scars stuck (like TNF-alpha and IL-6), and supports deep, meaningful healing - even long after the fact.
Do you have an upcoming planned cesarean?
Experts suggest that adhesion development probably happens in the first 3-5 days after a surgical procedure so getting light on as soon as possible in the postpartum period may be helpful. If that’s not possible get your device on your abdomen in the weeks after your baby’s birth.
Do you have a red light therapy tool in your birth bag? Here’s my top home device recommendations and a comparison chart of popular devices.
Additional Resources:
https://www.medscape.org/viewarticle/587422
