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Human Reproduction, Vol. 18, No. 1, 217-218, January 2003
© 2003 European Society of Human Reproduction and Embryology

Caesarian section and subfertility

D.J. Murphy1, G.M. Stirrat and J. Heron and the ALSPAC Study Team

University Department of Obstetrics and Gynaecology, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK 1 To whom correspondence should be addressed. e-mail: d.j.Murphy{at}dundee.ac.uk

Dear Sir,

In response to our paper (Murphy et al., 2002Go), Porter and Bhattacharya are correct in their assertion that the relationships between Caesarean Section and reproductive outcomes are complex. We did not aim to simplify potential associations but chose to focus on a particular outcome, ‘time to conception’ which had been well defined and reported among the ALSPAC cohort of women. A major strength of our research was the ability to consider and adjust for important sources of confounding but we would not yet describe the association as causal. We have fully endorsed the need for further in-depth research, addressing potential consequences of delivery by Caesarean Section and their causes, and agree that a combination of qualitative and quantitative methods will enhance our understanding of maternal concerns as well as clinically defined outcomes.

The media interest in mode of delivery is likely to continue and should be employed to our advantage. We should aim to educate women who seek information on mode of delivery as well as our colleagues who can access specialist medical journals. Journalists are increasingly prepared to report study limitations and the need for further replication and clarification of early research findings. These issues were emphasised in both newspaper and radio reports following our recent publication. We look forward to the results of forthcoming and future research in this area and the resulting debate.

References

Murphy, D.J., Stirrat, G.M. and Heron, J. (2002) The relationship between Caesarean section and subfertility in a population-based sample of 14 541 pregnancies. Hum. Reprod., 17, 1914–1917.[Abstract/Free Full Text]


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This Article
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