Caesarean section has been a great innovation in reproductive healthcare and can be lifesaving for the mother and/or baby. Many mothers have a caesarean birth, but some are unaware of the potential risks after a caesarean birth, reduced future fertility being one of them. There is some evidence that fertility is reduced after birth by caesarean section compared to having a vaginal birth.

After a caesarean, the scar on the uterus can form a cavity which is called an isthmocoele. An isthmocoele is uncommon but can occasionally cause fertility issues and sometimes abnormal menstrual loss. The fluid may interfere with embryo implantation which may be why conceiving can be difficult. It is possible to improve fertility by repairing the isthmocoele surgically, however this surgery needs further research to confirm if this treatment consistently improves fertility.

How do you know if you have isthmocoele?

Some women have abnormal brown discharge vaginally and some women have no symptoms. Sometimes the isthmocoele is detected on ultrasound scan.

Are there any other risks of isthmocoele?

Other risks of an isthmocoele are unknown. 


If you’ve had a caesarean section and have been trying to conceive without success it is important to seek assistance. Care Fertility understands the complications of a caesarean section, can address questions about you and your partner’s fertility and help develop a personalised fertility treatment. 

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