Published online Mar 26, 2019. doi: 10.12998/wjcc.v7.i6.753
Peer-review started: November 29, 2018
First decision: January 8, 2019
Revised: February 4, 2019
Accepted: February 26, 2019
Article in press: February 26, 2019
Published online: March 26, 2019
Core tip: Scarring associated with cesarean sections has been implicated with infertility. A possible link between cesarean section and infertility is the development of triangle shape scar named isthmocele. Isthmoceles can cause a retrograde passage of mucosanguineous content to the uterine cavity, instigating inflammation. This could lead to the development of hydrometra. We present a case of a woman who had a previous cesarean section and a latter failure to get pregnant by natural means. During the in vitro fertilization (IVF) procedure in our clinic, hydrometra developed. Upon reviewing transvaginal ultrasound, an isthmocele was found. Hysteroscopy correction of the isthmocele abolished hydrometra, and the patient was able to get pregnant by IVF. Physicians and other personnel should keep in mind that isthmocele is a possible cause of secondary infertility, which could be linked to the formation persistent hydrometra.