Saraswat Lucky, Porter Maureen, Bhattacharya Sohinee, Bhattacharya Siladitya
Department of Obstetrics and Gynaecology, Aberdeen Maternity Hospital, Cornhill Road, Aberdeen AB25 2ZL, UK.
Reprod Biomed Online. 2008 Aug;17(2):259-64. doi: 10.1016/s1472-6483(10)60203-9.
Rising Caesarean section (CS) rates have fuelled concerns about the effect of abdominal delivery on female fertility due to post-surgical complications affecting the Fallopian tubes. The association between exposure to CS and subsequent tubal infertility was explored by means of a case-control study. This study compared 220 women with secondary infertility due to tubal factor with 1244 women with secondary infertility due to non-tubal causes and 18,376 fertile women (women with a previous live birth followed by another live birth during the time period when the infertile cases were trying to conceive) in terms of exposure to CS. Exposure to CS in women with secondary tubal infertility was similar to other infertile women (21.4% versus 21.6%) but lower in fertile controls (14.5%). After adjusting for confounding factors, CS does not appear to be significantly associated with tubal infertility [adjusted odds ratio (95% confidence interval) for previous CS for infertile and fertile controls were 1.06 (0.73-1.52) and 1.2 (0.9-1.7), respectively]. However, other factors that were found to be predictive of secondary tubal infertility include history of intrauterine device use, pelvic inflammatory disease, ectopic pregnancy, endometriosis and previous pelvic surgery.
剖宫产率的不断上升引发了人们对腹部分娩对女性生育能力影响的担忧，因为手术并发症会影响输卵管。通过一项病例对照研究探讨了剖宫产与随后输卵管性不孕之间的关联。该研究比较了220名因输卵管因素导致继发性不孕的女性、1244名因非输卵管因素导致继发性不孕的女性以及18376名有生育能力的女性（在不孕病例试图受孕期间，曾有过一次活产且随后又有一次活产的女性）的剖宫产暴露情况。继发性输卵管性不孕女性的剖宫产暴露率与其他不孕女性相似（21.4%对21.6%），但低于有生育能力的对照组（14.5%）。在对混杂因素进行调整后，剖宫产似乎与输卵管性不孕无显著关联[不孕和有生育能力对照组既往剖宫产的调整比值比（95%置信区间）分别为1.06（0.73 - 1.52）和1.2（0.9 - 1.7）]。然而，其他被发现可预测继发性输卵管性不孕的因素包括宫内节育器使用史、盆腔炎、异位妊娠、子宫内膜异位症和既往盆腔手术史。
