IMR Press / CEOG / Volume 48 / Issue 4 / DOI: 10.31083/j.ceog4804125
Open Access Review
The impact of Cesarean section on female fertility: a narrative review
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1 Clinical Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, 1090 Vienna, Austria
2 Department of Obstetrics and Gynecology, Medical University of Vienna, 1090 Vienna, Austria
Clin. Exp. Obstet. Gynecol. 2021, 48(4), 781–786; https://doi.org/10.31083/j.ceog4804125
Submitted: 11 April 2021 | Revised: 18 May 2021 | Accepted: 10 June 2021 | Published: 15 August 2021
(This article belongs to the Special Issue Caesarean Section Today - “Caesarology in the 21st Century”)
Abstract

Objective: The mode of giving birth has changed over the years. In 1990, approximately 10% of women delivered by Cesarean section (CS), whereas this procedure is performed daily in obstetrics today. When a surgical intervention performed, it is necessary to consider special risks and complications, including long-term effects. Mechanism: This review focuses on fertility after CS. Evidence suggests that many women who aim to have subsequent children have difficulties becoming pregnant after they have delivered by CS. Findings: There are several causes for subfertility/infertility after CS, including post-Cesarean niches, intraabdominal adhesions, and the preference for a smaller family size, among others. Conclusion: This review provides an overview of the available literature, which supports the conclusion that CS is associated with decreased odds of subsequent pregnancy and live birth.

Keywords
Cesarean section
Fertility
Infertility
Niche
Fallopian tubes
Adhesions
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