Does Cesarean Delivery Affect Future Fertility Chances?

Does a cesarean section affect the chances of conception?

Hello, Doctor! In November 2013, at 36 weeks gestation (the weight was 3200 grams), a physician informed me that the fetus might be overweight at the due date, which could lead to complications during natural delivery (is this normal?).
Another physician suggested an early delivery, so I went to the hospital around 10 PM on the 15th to receive induction.
By around 2 AM, I was dilated to about two centimeters, my water broke, but the cervical dilation was slow, reaching only three and a half centimeters before it slowed down.
The baby's head was already engaged in the cervix, so I was forced to have a cesarean section around 3 AM.
Fortunately, both mother and baby are safe.
Recently, after not conceiving for over two years, I visited another doctor who mentioned that 1.
the incision site was too low, and 2.
the eggs are small (is there a size difference?).
Therefore, I would like to ask if the above situations could affect my chances of conception.
I look forward to your reply, thank you!

You Shou Hao Xian, 30~39 year old female. Ask Date: 2016/06/17

Dr. Lü Lizheng reply Obstetrics and Gynecology

1.
Under normal circumstances, a cesarean section does not affect the chances of future pregnancies.
However, in a small number of cases, some women may experience adhesions in the fallopian tubes after surgery, which can hinder their function and prevent sperm and egg from meeting properly, leading to difficulties in conceiving.
This can be confirmed through a hysterosalpingogram or laparoscopy.

2.
There are many reasons for difficulty in conceiving, and numerous other factors should also be considered.
It is advisable to consult a fertility specialist for treatment.

Sincerely, Dr.
Lyu Li-Cheng, Taoyuan Hospital.

Reply Date: 2016/06/17

More Info

Cesarean delivery, commonly referred to as C-section, can have implications for future fertility, but the effects can vary widely among individuals. In your case, it is essential to consider several factors that may influence your fertility after a C-section.

Firstly, the surgical procedure itself typically does not directly affect a woman's ability to conceive in the future. Many women who have had a C-section go on to have successful pregnancies afterward. However, there are some potential complications associated with C-sections that could indirectly impact fertility. For instance, if there were any complications during the surgery, such as infection or significant scarring, these could potentially affect the uterus and, in turn, fertility.

One of the concerns raised by your doctor regarding the "position of the incision" could relate to the type of incision made during the C-section. The most common type of incision is a horizontal (bikini) incision, which generally has fewer complications and is associated with better outcomes in subsequent pregnancies. A vertical incision, while less common, may have more implications for future pregnancies, including a higher risk of uterine rupture in subsequent pregnancies. If your incision was indeed lower on the uterus, it is important to discuss this with your healthcare provider to understand any specific risks it may pose.

Regarding the mention of "egg size," it is true that egg quality and size can vary among women and can influence fertility. However, the size of the eggs is not typically a direct result of having a C-section. Factors such as age, hormonal balance, and overall reproductive health are more significant determinants of egg quality and size. If your doctor has indicated that your eggs are smaller than average, it may be worthwhile to explore this further with a fertility specialist. They can provide insights into whether this is a concern and what steps you might take to improve your fertility.

In terms of timing, if you have been trying to conceive for over two years without success, it may be beneficial to seek a comprehensive fertility evaluation. This can include assessments of both partners to identify any underlying issues that may be contributing to difficulties in conceiving. Factors such as ovulation disorders, sperm quality, and uterine health should all be considered.

Additionally, it is essential to maintain a healthy lifestyle, as factors like diet, exercise, and stress management can significantly impact fertility. If you are considering trying to conceive again, it is advisable to consult with your healthcare provider to discuss your specific situation, including any concerns about your previous C-section and how it may relate to your current fertility status.

In conclusion, while a C-section can have implications for future pregnancies, many women successfully conceive after such a delivery. It is crucial to address any specific concerns with your healthcare provider, who can guide you through the process and help you understand your options moving forward.

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