Pnm-7: The Correlation of Cesaraen Section and Subsequent Subfertility

Background: Cesaraen section (CS) rates have risen rapidly throughout the developed world during the last 20 years and now stand at approximately one birth in five . Many factors have contributed to this rise , including maternal choice, increased maternal age and more liberal use of the procedure for women with previous CS , breech and multiple pregnancy. Cocerns have been expressed about the financial costs of the operation and the consequences for the women involved. Whilst recent reviews have reported some conventionally held beliefs about the potential benefits of contradictory and could as easily be used to make a cause for increasing the CS rate. One of the issues causing widespread concern is the effectof CS on future fertility . The aim of this study was to determine the correlation between cesaraen section and subfertility. Materials and Methods: This systematic review assessed more of 16 studies from books, articles and different sites of internet about the correlation between cesaraen section and subfertility in 2000-2010. Results: Heminki et al. (1998) reported that women who have their first baby by CS tend to have fewer childern and only 47% if those delivering by CS went on to have a subsequent pregnancy over a 5-year period compared with 57% of those having an instrumental delivery and 62% of those with a spontaneous vaginal delivery .Lietch et al. (1999) found that 50% of women having a Cs didn,t return with another pregnancy. Jolly et al. (2002) showed that 42% of women who delivered by CS, had no further childern after 5 years compared 29% of those with a spontaneous vaginal delivery. Morphy et al. (2003) also demonstrated an assiciation between CS and prolonged time to conception. 14.4 % of those having a CS taking more than a year to conceive, compared to 8.5% of those not having a CS. Epidemiological studies have confirmed an assiciation between CS and infertility. What has been less widely studied is the nature of the link. As yet it is unclear whether reproductive potential is compromised by the effect of pelvic surgery, or whether women are deliberatedly limiting their fertility following CS. Other findings will explain in full text of paper. Conclusion: All of the Epidemiological studies about the assiciation between CS and subfertility, reported the negative assiciation between CS and future fertility .What are needed now are qualtitative studies to determine the role and nature of such correlation. Reliable evidence on long term consequences of cesarean section is essential if women to be offered informed choice with regards to mode of delivery.