C-Section Tied to Subsequent Reduced Fecundability, Infertility

THURSDAY, Jan. 4, 2024 (HealthDay News) -- Among women with more than one child, those who had a previous cesarean delivery subsequently had a lower fecundability ratio and an increased infertility risk than those who had a vaginal delivery, according to a study recently published in the American Journal of Obstetrics & Gynecology.

Yeneabeba Tilahun Sima, M.D., from University of Bergen in Norway, and colleagues assessed the bidirectional relationship between cesarean delivery and fecundability. The analysis included data from 74,024 women identified in the Norwegian Mother, Father, and Child Cohort study linked with the Medical Birth Registry of Norway.

The researchers found that the proportion of women with infertility was 7.3 percent among women with a previous vaginal delivery and 9.9 percent among women with a previous cesarean delivery (adjusted relative risk, 1.21). A lower fecundability ratio was also seen among women with a previous cesarean delivery versus those with a previous vaginal delivery (0.90). For the reverse association, women who did not conceive within ≥12 cycles had a higher risk for cesarean delivery (adjusted relative risk, 1.57) compared with women who conceived within the first two cycles. When controlling for sociodemographic and clinical risk factors, findings persisted across parity groups.

"Our findings suggest that the observed reduced ability to conceive after C-section may be linked to underlying maternal conditions not registered in our data or not yet clinically emerged, and the surgical procedure may not directly influence this pathway," Sima said in a statement.

Abstract/Full Text