FERTILITY IN ANOVULATORY PATIENTS AFTER PRIMARY CESAREAN-SECTION

OBJECTIVE: To evaluate the fertility potential after primary cesarean section (CS) in anovulatory patients treated for ovulation induction w ith gonadotropins. STUDY DESIGN: A controlled, prospective study was c onducted on 97 anovulatory patients who delivered a neonate either abd ominally or vaginally after ovulation induction with human menopausal gonadotropin/human chorionic gonadotropin (hMG/hCG). After four cycles of hMG/hCG therapy, cumulative pregnancy rates and abortions were obs erved. In both groups, patients who did not conceive underwent hystero salpingography to evaluate uterine and tubal patency. RESULTS: The cum ulative pregnancy rate in the anovulatory, post-cesarean section patie nts treated with hMG/hCG was 61.9%, as compared to 59.6% in the contro l group (statistically nonsignificant). The abortion rate was similar in both groups. CONCLUSION: The risk of uterine or tubal infertility i s probably not substantially increased in patients on whom uncomplicat ed cesarean sections have been performed. Anovulatory patients who con ceive after treatment with gonadotropins and deliver abdominally shoul d be referred for medical treatment before evaluation of any uterine o r tubal infertility.