The problem is that the healing of the uterus at the incision site during surgical delivery is not always complete.
Caesarean sections are regulated by the relevant clinical protocol, have clear medical indications and are vital in certain clinical situations.
However, it is not for nothing that the world has begun to talk about the ‘caesarean section epidemic’.
In some countries, such as Brazil, 80% of all deliveries are performed using the surgical method.
Quite often, in 42-84% of cases, a small cavity – a uterine niche – forms at the site of the caesarean section scar.
In this niche, there is stagnation of menstrual blood and mucus, which can provoke an inflammatory process.
Reproductive specialists are concerned about the fact that the uterine niche creates an unfavourable environment for both the sperm and the embryo:
- Stagnation of menstrual blood and mucus in the niche triggers inflammatory changes, which can reduce sperm motility;
- The contents of the niche are embryotoxic – in contact with these inflammatory substances, the embryo can stop developing
- The main hormone, progesterone, stops working in the uterus against the background of inflammation, and the embryo does not attach to the uterus;
- The contractility of the uterus is impaired both due to the presence of a defect in the uterus and the inflammatory process, against which the embryo can be pushed out by the uterus;
- Niches can be accompanied by symptoms of pain and prolonged smearing bloody spotting, which is not conducive to regular sexual activity;
- The procedure of transferring embryos into the uterine cavity in an in vitro fertilisation (IVF) programme can be complicated by the presence of a uterine niche;
Therefore, niches can cause secondary infertility in women who have not previously had fertility problems, or be the cause of negative in vitro fertilisation attempts.
When planning a large family, it is important to know that natural childbirth is an important element in achieving success on this path.