Object. To study the influence of surgical correction of uterine scar incompetence after Caesarian section on the possibility of spontaneous pregnancy or pregnancy after IVF and to develop the algorithm of management of such patients. Matrial and methods. The study involved 28 infertile patients younger 42 years with uterine scar incompetence after planned or immediate Caesarian section. Results. The results confirmed that the secondary infertility can be associated with uterine scar incompetence. The scar resection performed by highly-qualified surgeon provides the competence of suture formation and can prevent uterine scar rupture during pregnancy. Conclusion. It was justified the necessity of surgical excision of incompetence myometrial scar tissue formatted after Caesarian section in the beginning of infertility management.