C-Section and Infertility: Does A Prior C-Section Increase Your Risk Of Secondary Infertility?

Double board certified OBGYN and REI, Dr. Natalie Crawford, discusses prior c-sections and your risk of secondary infertility. With the increase in c-sections, this is an important conversation to have.

Questions answered:

What do studies say about prior c-sections and your chances of getting pregnant?

Why are c-sections done?

Can it take longer to get pregnant a second time if you have had a c-section?

What do IVF studies say?

Why might it take longer to get pregnant after a c-section?

What is a c-section niche or Isthmocele?

What are the symptoms of a Isthmocele?

How can scar defects and abnormal bleeding affect your reproductive organs?

How can this be fixed?

How long should you let your body heal after a c-section before trying to conceive again?

When should you see a doctor about a potential Isthmocele?

Resources:

Vissers J, Sluckin TC, Repelaer van Driel-Delprat CC, Schats R, de Groot CJM, Lambalk CB, Twisk JWR, Huirne JAF.. Reduced pregnancy and live birth rates after in vitro fertilization in women with previous Caesarean section: a retrospective cohort study. Hum Reprod 2020;35:595–604.

Gurol-Urganci I, Bou-Antoun S, Lim CP, Cromwell DA, Mahmood TA, Templeton A, van der Meulen JH. Impact of Caesarean section on subsequent fertility: a systematic review and meta-analysis. Hum Reprod. 2013 Jul;28(7):1943-52. doi: 10.1093/humrep/det130. Epub 2013 May 3. PMID: 23644593.

Jacob L, Weber K, Sechet I, Macharey G, Kostev K, Ziller V. Caesarean section and its impact on fertility and time to a subsequent pregnancy in Germany: a database analysis in gynecological practices. Arch Gynecol Obstet. 2016 Nov;294(5):1005-1010. doi: 10.1007/s00404-016-4160-4. Epub 2016 Aug 3. PMID: 27488697.

‌Bider D, Blankstein J, Tur-Kaspa I. Fertility in anovulatory patients after primary cesarean section. J Reprod Med. 1998 Oct;43(10):869-71. PMID: 9800669.

‌Smith GC, Wood AM, Pell JP, Dobbie R. First cesarean birth and subsequent fertility. Fertil Steril. 2006 Jan;85(1):90-5. doi: 10.1016/j.fertnstert.2005.07.1289. PMID: 16412736.

‌Murji A, Sanders AP, Monteiro I, Haiderbhai S, Matelski J, Walsh C, Abbott JA, Munro MG, Maheux-Lacroix S; International Federation of Gynecology and Obstetrics (FIGO) Committee on Menstrual Disorders and Related Health Impacts. Cesarean scar defects and abnormal uterine bleeding: a systematic review and meta-analysis. Fertil Steril. 2022 Oct;118(4):758-766. doi: 10.1016/j.fertnstert.2022.06.031. Epub 2022 Aug 17. PMID: 35985862.

‌Vissers J, Hehenkamp W, Lambalk CB, Huirne JA. Post-Caesarean section niche-related impaired fertility: hypothetical mechanisms. Hum Reprod. 2020 Jul 1;35(7):1484-1494. doi: 10.1093/humrep/deaa094. PMID: 32613231; PMCID: PMC7568911.