title: Fertility in anovulatory patients after primary cesarean section.
abstract: OBJECTIVE
  To evaluate the fertility potential after primary cesarean section (CS) in anovulatory patients treated for ovulation induction with gonadotropins.
  
  
  METHODS
  A controlled, prospective study was conducted on 97 anovulatory patients who delivered a neonate either abdominally 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 observed. In both groups, patients who did not conceive underwent hysterosalpingography to evaluate uterine and tubal patency.
  
  
  RESULTS
  The cumulative pregnancy rate in the anovulatory, post-cesarean section patients treated with hMG/hCG was 61.9%, as compared to 59.6% in the control group (statistically nonsignificant). The abortion rate was similar in both groups.
  
  
  CONCLUSIONS
  The risk of uterine or tubal infertility is probably not substantially increased in patients on whom uncomplicated cesarean sections have been performed. Anovulatory patients who conceive after treatment with gonadotropins and deliver abdominally should be referred for medical treatment before evaluation of any uterine or tubal infertility.
authors.affiliation: Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: D
authors.initials: D
authors.lastname: Bider
authors.forename: J
authors.initials: J
authors.lastname: Blankstein
authors.forename: I
authors.initials: I
authors.lastname: Tur-Kaspa
mesh_terms: D000328:Adult; D000858:Anovulation / Q000188:drug therapy / Q000503:physiopathology*; D002585:Cesarean Section / Q000009:adverse effects*; D005187:Fallopian Tubes / Q000473:pathology; D005260:Female; D006062:Gonadotropins / Q000627:therapeutic use*; D006801:Humans; D007247:Infertility, Female / Q000503:physiopathology*; D011247:Pregnancy; D011446:Prospective Studies; D014599:Uterus / Q000473:pathology
chemical_list: D006062:Gonadotropins