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Fertility in anovulatory patients after primary cesarean section
D Bider1, J Blankstein, I Tur-Kaspa
1Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer, Israel.
The Journal of Reproductive Medicine
|November 4, 1998
Summary
Women with anovulation who underwent a cesarean section (CS) and received gonadotropin therapy showed similar fertility potential compared to controls. Uncomplicated CS does not appear to significantly increase infertility risk in these patients.
Area of Science:
- Reproductive Endocrinology
- Obstetrics and Gynecology
Background:
- Anovulatory infertility affects a significant portion of women seeking fertility treatment.
- Cesarean section (CS) is a common obstetric procedure, and its impact on subsequent fertility warrants investigation.
- Ovulation induction with gonadotropins is a standard treatment for anovulatory infertility.
Purpose of the Study:
- To assess the fertility potential in anovulatory women following a primary cesarean section (CS) after ovulation induction with gonadotropins.
- To compare pregnancy and abortion rates between anovulatory patients with a history of CS and a control group.
Main Methods:
- A prospective, controlled study involving 97 anovulatory patients treated with human menopausal gonadotropin/human chorionic gonadotropin (hMG/hCG).
- Patients were categorized based on delivery mode (abdominal/vaginal after CS or vaginal).
- Cumulative pregnancy rates, abortion rates, and tubal/uterine patency via hysterosalpingography were evaluated after four cycles.
Main Results:
- The cumulative pregnancy rate was comparable between the post-CS group (61.9%) and the control group (59.6%), with no statistically significant difference.
- Abortion rates were similar in both anovulatory patient groups.
Conclusions:
- Uncomplicated cesarean sections likely do not substantially increase the risk of uterine or tubal infertility in anovulatory patients undergoing gonadotropin therapy.
- Anovulatory patients conceiving after gonadotropin treatment and abdominal delivery should receive medical management before infertility evaluations.