The 36-year-old reality discusses the possibility of another, high-risk pregnancy in a preview for the April 2 episode of Keeping Up with the Kardashians.
"I want my kids to have siblings, but the doctors don't feel like it's safe for me," she adds in a confessional shot.
Kardashian already shares 3-year-old daughter North and 15-month-old son Saint with West. She previously considered using a surrogate for a third child after doctors told her another pregnancy might be dangerous.
"Using a surrogate is not an unreasonable option," a fertility specialist told the star in Season 12. "If our goal is to grow your family like you want to, then a surrogate makes sense."
Kardashian had preeclampsia during her first pregnancy and experienced placenta accreta -- a condition where the placenta remains attached to the uterus -- after giving birth to North. She also had complications while pregnant with Saint.
Keeping Up with the Kardashians returned for a 13th season this month. Kardashian opened up about her Paris robbery for the first time on last week's episode, saying she expected to be raped and killed during the October incident.