MYTH: IVF pregnancies always lead to Caesarean section delivery
FACT: An IVF pregnancy is no different from a natural one, and the need for a C-section may arise because of certain complications in pregnancy that may occur even with natural conception, and not because of IVF.
However, women conceiving following IVF may be older and the babies conceived through ART are considered ‘Precious Babies’, because they are a result of a battle against long standing years of infertility. This may be the reason why some couples opt for a planned or elective Caesarean delivery rather than taking a risk with vaginal birth.
Not surprisingly, infertile women who conceive either with or without IVF are older. Consequently, they are much more apt to have chronic disorders such as diabetes, hypertension, and obesity. Moreover, they are more apt to have undergone abdominal or uterine surgery, especially myomectomy, conization, operative hysteroscopy, and endometriosis. It is not surprising that the strongest confounders in this study predisposing to cesarean delivery were age and previous uterine surgery. It also is known that advanced maternal age is associated with increased stillbirths and is a risk factor for cesarean delivery. In any case, it is certainly true from this study that the rates of cesarean delivery were higher among infertile women.
It is also interesting to note that cesarean delivery rates were significantly higher in all infertile women, regardless of whether they underwent IVF to achieve pregnancy. In fact, although cesarean deliveries were significantly more frequent after IVF than in other infertile women, the major increase was observed in infertile women regardless of how they conceived. In retrospect, this too should be obvious if advanced age and prior uterine surgery are the major risk factors in all infertile women.
So why did I choose to highlight this particular study?
It is simply because all healthcare providers caring for these women should be aware that infertile women are at increased risk during their pregnancies and should be monitored closely. I think that is a lesson well worth remembering.The same was true for the infertile women who did not undergo IVF.