The impact of Cesarean section on female fertility: a narrative review

Abstract

The impact of Cesarean section on female fertility: a narrative review Lorenz Hinterleitner1 , Herbert Kiss2 , Johannes Ott1, * 1 Clinical Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, 1090 Vienna, Austria 2Department of Obstetrics and Gynecology, Medical University of Vienna, 1090 Vienna, Austria *Correspondence: johannes.ott@meduniwien.ac.at (Johannes Ott) DOI:10.31083/j.ceog4804125 This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/). Submitted: 11 April 2021 Revised: 18 May 2021 Accepted: 10 June 2021 Published: 15 August 2021 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 postCesarean 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