Monday, March 29, 2021

Previous Caesarean section reduces IVF pregnancy rates

Many IVF patients are subjected to a caesarean section by their obstetrician when they get pregnant, because this is considered to be a “precious pregnancy”, even though there is no real medical reason for them not to have a normal vaginal birth.

The problem is that when they come back for their next baby, the IVF success rates drop because of their earlier caesarean section. The scar on the uterus reduces the chances of the embryo implanting.

The risk is increased if a post-Caesarean scar defect (also called a niche) is seen on the ultrasound scan .  A niche is an indentation of the uterine wall of at least 2 mm at the site of the Caesarean scar, assessed by transvaginal ultrasound .  Some of  these patients also have an accumulation of endometrial fluid around the niche.

The reasons for the lower pregnancy rates after a Caesarean section remain to be elucidated. Some studies suggest that incomplete uterine healing and post-operative infection may play a key role in interfering with embryo implantation

Also, implantation very close to or in the niche increases the risk of a miscarriage, because the niche is not a favourable site for implantation.

Please don't allow your doctor to do a routine elective caesarean section for you ! There needs to be a very good medical reason for performing this major surgical procedure !


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