RATE OF SECONDARY INFERTILITY IN PATIENTS AFTER CESAREAN SECTION VERSUS NORMAL VAGINAL DELIVERY
DOI:
https://doi.org/10.70520/kjms.v19i1.843Keywords:
Cesarean Section, Secondary infertility, vaginal delivery, cesarean scar defect, tubal pahtology, reproductive outcomesAbstract
Background: Rising rates of secondary infertility may be linked to increased rates of Caesarean sections. Caesarean sections can result in reproductive morbidity due to scar defects, vascular adhesions, tubal pathology, and other long-term complications that may hinder reproductive capacity.
Objective: To compare the frequency of secondary infertility-associated reproductive tract abnormalities among women with previous cesarean section versus previous vaginal delivery presenting to a tertiary care infertility clinic.
Methods: This observational cross-sectional study was conducted at Hayatabad Medical Complex Peshawar, Department of Gynecology and Obstetrics from May 6, 2025, to November 5, 2025. A total of 190 women with secondary infertility were recruited through non-probability consecutive sampling. A total of 190 women with secondary infertility were enrolled through non-probability consecutive sampling, with 95 participants in each group based on previous mode of delivery.
Results: Caesar section had a higher frequency of secondary infertility 71.6% when compared to vaginal delivery 44.2% with a p value of 0.001. Cesarean scar niche was present in 53.7% of women with a previous Cesarean delivery. Unilateral blockage 22.6% Vs 10.5%, bilateral blockage 19% vs 6.6% were noted in the Cesarean group.
Conclusion: The women with a past Cesarean section had a higher incidence of secondary infertility which could be explained by secondary structural changes due to surgery and tubal pathology. This becomes even more important when considering a Cesarean delivery to assist in making decisions and when considering a more urgent fertility workup when indicated.
Keywords: Secondary infertility; Cesarean section; Vaginal delivery; Cesarean scar defect; Tubal pathology; Reproductive outcomes
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