The effect of cesarean section and vaginal delivery on ovarian reserve in infertile women

Yıl 2022, Cilt: 39 Sayı: 3, 833 - 837, 30.08.2022

Kübra Baki Erin , Deniz Kulaksız

Öz

According to the data of the World Health Organization (WHO), although the rate of cesarean section is increasing worldwide, one out of every five births is performed by cesarean section. Cesarean section is life saving for both mother and baby depending on the situation. However, it also brings some complications. Its effect on fertility also raises concerns. The aim of the present study was to investigate the effect of cesarean section on ovarian reserve.
Anti-Mullerian hormone, Follicle-Stimulating Hormone, Luteinizing Hormone, Estradiol, antral follicle count, ovarian volume, and ovarian elastography results of 120 patients under the age of 30 who were not obese and were compatible with the criteria for unexplained infertility of the American Society for Reproductive Medicine were analyzed in both pre-pregnancy and postpartum period. There were 57 patients with vaginal delivery and 63 patients with cesarean section. Differences between the groups according to the mode of delivery and between the pre-pregnancy and postpartum groups were investigated.
There was no statistically significant difference for the vaginal birth group in terms of AFC, AMH, FSH, LH, E2, SWE and ovarian volumes between pre-pregnancy and postpartum. In the cesarean section group, AFC, AMH and ovarian volumes were found to be significantly lower in the postpartum period than before pregnancy.
As a result, cesarean delivery may have negative consequences on ovarian reserve tests.

Anahtar Kelimeler

AMH, cesarean, elastography, ovarian reserve, vaginal birth

Kaynakça

• Antoine C, Young BK. Cesarean section one hundred years 1920-2020: The Good, the Bad and the Ugly. J Perinat Med. 2020;49(1):5–16.
• NICE guideline [NG192]. Caesarean Birth. Ulster Med J [Internet]. 2021;(March). Available from: https://www.nice.org.uk/guidance/ng192
• Erin R, İssak A, Baki Erin K, Kulaksiz D, Bayoğlu Tekin Y. The Efficiency of Temporary Uterine Artery Ligation on Prevention of the Bleeding in Cesarean Section. Gynecol Obstet Invest. 2021;1–8.
• Erin R, Burkankulu Agirbas D, Erin KB, Kulaksız D. Prolonged Postpartum Persistent Urinary Retention After Cesarean Section: A Case Report and Literature Review. Gynecol Obstet Reprod Med. 2019;25(2):120–2.
• Erin R, Erin KB, Ağırbaş DB, Okatan BK. Endometriosis of Rectus Muscle Excised During Cesarean Section: A Case Report and Literature Review. Gynecol Obstet Reprod Med. 2017;23(1):45–7.
• Chien P. Global rising rates of caesarean sections. BJOG An Int J Obstet Gynaecol. 2021;128(5):781–2.
• Gurol-Urganci I, Bou-Antoun S, Lim CP, Cromwell DA, Mahmood TA, Templeton A, et al. Impact of Caesarean section on subsequent fertility: a systematic review and meta-analysis. Hum Reprod. 2013;28(7):1943–52.
• Hemminki E. Impact of Caesarean section on future pregnancy - A review of cohort studies. Paediatr Perinat Epidemiol. 1996;10(4):366–79.
• Mollison J, Porter M, Campbell D, Bhattacharya S. Primary mode of delivery and subsequent pregnancy. BJOG An Int J Obstet Gynaecol. 2005;112(8):1061–5.
• Gurol-Urganci I, Cromwell DA, Mahmood TA, Van Der Meulen JH, Templeton A. A population-based cohort study of the effect of Caesarean section on subsequent fertility. Hum Reprod. 2014;29(6):1320–6.
• Moini A, Pirjani R, Rabiei M, Nurzadeh M, Sepidarkish M, Hosseini R, et al. Can delivery mode influence future ovarian reserve? Anti-Mullerian hormone levels and antral follicle count following cesarean section: A prospective cohort study. J Ovarian Res. 2019;12(1):1–7.
• Jirge PR. Ovarian reserve tests. J Hum Reprod Sci. 2011;4(3):108–13.
• Penzias A, Azziz R, Bendikson K, Falcone T, Hansen K, Hill M, et al. Testing and interpreting measures of ovarian reserve: a committee opinion. Fertil Steril. 2020;114(6):1151–7.
• Rombauts L, Onwude JL, Chew HW, Vollenhoven BJ. The predictive value of antral follicle count remains unchanged across the menstrual cycle. Fertil Steril [Internet]. 2011;96(6):1514–8. Available from: http://dx.doi.org/10.1016/j.fertnstert.2011.09.005
• Bence K, Krisztina P, Rudolf L, Ervin B, Péter T. Application of ultrasound elastography in obstetrics and gynecology. Orv Hetil. 2021;162(18):690–5.
• Workup I, Specialist H. Infertility Workup for the Women’s Health Specialist. Obstet Gynecol. 2019;133(6):1294–5.
• McCredie S, Ledger W, Venetis CA. Anti-Müllerian hormone kinetics in pregnancy and post-partum: a systematic review. Reprod Biomed Online [Internet]. 2017;34(5):522–33. Available from: http://dx.doi.org/10.1016/j.rbmo.2017.02.005
• Ogawa K, Urayama KY, Tanigaki S, Sago H, Sato S, Saito S, et al. Association between very advanced maternal age and adverse pregnancy outcomes: A cross sectional Japanese study. BMC Pregnancy Childbirth. 2017;17(1):1–10.
• Lodge-Tulloch NA, Elias FTS, Pudwell J, Gaudet L, Walker M, Smith GN, et al. Caesarean section in pregnancies conceived by assisted reproductive technology: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2021;21(1):1–13.
• Rydahl E, Declercq E, Juhl M, Maimburg RD. Cesarean section on a rise—Does advanced maternal age explain the increase? A population register-based study. PLoS One. 2019;14(1):1–16.
• Evers EC, McDermott KC, Blomquist JL, Handa VL. Mode of delivery and subsequent fertility. Hum Reprod [Internet]. 2014 Nov 1;29(11):2569–74. Available from: https://academic.oup.com/humrep/article-lookup/doi/10.1093/humrep/deu197
• Moolhuijsen LME, Visser JA. Anti-Müllerian Hormone and Ovarian Reserve: Update on Assessing Ovarian Function. J Clin Endocrinol Metab [Internet]. 2020 Nov 1;105(11). Available from: https://academic.oup.com/jcem/article/doi/10.1210/clinem/dgaa513/5890022
• Podfigurna A, Lukaszuk K, Czyzyk A, Kunicki M, Maciejewska-Jeske M, Jakiel G, et al. Testing ovarian reserve in pre-menopausal women: why, whom and how? Maturitas. 2018;109(November):112–7.
• Zhou SJ, Zhao MJ, Li C, Su X. The comparison of evaluative effectiveness between antral follicle count/age ratio and ovarian response prediction index for the ovarian reserve and response functions in infertile women. Medicine (Baltimore). 2020;99(36):e21979.
• De Vasconcelos GL, MacUlan R, Da Cunha EV, Silva AWB, Batista ALS, Donato MAM, et al. Antral follicular count and its relationship with ovarian volume, preantral follicle population and survival, oocyte meiotic progression and ultrastructure of in vitro matured bovine cumulus-oocyte complexes. Zygote. 2020;
• Jehan S, Syed S. Association of ovarian reserve with age, BMI and serum FSH level in subfertile women. J Pak Med Assoc. 2016;66(4):409–13.
• Turan ÖD, Tunçyürek Ö, Ertekin E. Is shear wave elastography relevant in the diagnosis of polycystic ovarian syndrome? Med Ultrason. 2019;21(2):158–62.
• Luk J, Arici A. Does the ovarian reserve decrease from repeated ovulation stimulations? Curr Opin Obstet Gynecol. 2010;22(3):177–82.
• Kawamara K, Kelsey T, Hiraike O. Editorial: Ovarian Ageing: Pathophysiology and Recent Development of Maintaining Ovarian Reserve. Front Endocrinol (Lausanne) [Internet]. 2020 Sep 23;11. Available from: https://www.frontiersin.org/article/10.3389/fendo.2020.591764/full