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Does having a previous c-section impact future fertility?

When it was so easy to conceive the first time, many women are blindsided by difficulties conceiving the second time.  A recent study, “Association between mode of first delivery and subsequent fecundity and fertility” Kjerulff et al, in JAMA sheds light on a possible cause, cesarean delivery.

The National Center for Health Statistics reported 31.9% of all birth deliveries in the United States in 2018 was by Cesarean. Researchers set out to evaluate if there is a correlation between prior cesarean delivery and future conception difficulties. Their findings showed women who delivered their first child via c-section were 13% more likely to have infertility after 1 year of unprotected intercourse compared to women who delivered their first child vaginally. Even at 6 months, conceptions after c-sections were lower compared to after vaginal births.

Bottom line: C-sections are commonly performed to safely deliver babies but can be a risk factor for future infertility.  So, women having difficulties conceiving after previously delivering via c-section deserve prompt evaluation.  This can be with a very simple vaginal ultrasound, sometimes with a few tablespoons of sterile water placed into the uterus to look at the area of the c-section.

Mira Aubuchon, MD

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