Rehan Salim MD MRCOG

Consultant Gynaecologist & Subspecialist in Reproductive Medicine

Wolfson Fertility Centre - Hammersmith Hospital

The uterus is clearly a very important part of a woman’s reproductive system and has a crucial role in conception and a healthy pregnancy. There are anatomical, congenital or other conditions affect their normal functioning, hence causing problems in fertility.

What Uterine Factors Can Cause Infertility?

  • Problems in the Uterine Lining
    For successful pregnancy, the embryo must travel and attach itself to the endometrial lining of the uterus. This lining must be thick and have a good blood supply so that it may provide nutrients to the embryo to support its growth. The development of the endometrium is dependent on the levels of the hormones progesterone and estrogen.

  • Fibroids or Polyps
    Large polyps (abnormal growth) or fibroids in the uterus interfere with embryonic growth and development. Benign polyps or tumors (fibroids or myomas) are common in the women, and depending on their location and size, they can block fallopian tubes or become a hurdle in implantation.

  • Congenital Deformities and Malformations
    Uterine malformations and deformities cause problems with a woman′s ability to carry a pregnancy to full term. A commonly found one such condition is the T-shaped uterus. Women with such a uterus have an increased risk of miscarriages, preterm labour and delivery. Some women may be born with the uterus that is bicornuate, i.e. has two horns or other problems such as a uterine septum (scar tissue).

What are the symptoms of problems in the uterus?

Most of these conditions don’t show any symptoms and usually diagnosed when women are having a problem with conception. They sometimes may affect the menstrual cycle, and cause pelvic pain.

How are they diagnosed?

  • Imaging - The detection of such abnormalities or conditions is usually done using imaging techniques like an ultrasound or MRI as that helps gain a detailed picture into the organs to detect problems if any.

What is the treatment for such conditions affecting the uterus?

Submucous fibroids and endometrial polyps can be removed via a hysteroscope. It is important to remove the entire fibroid or polyp and therefore a more advances method, known as resection, is usually recommended.

Congenital defects or anatomical abnormalities are possible to correct in some cases depending on their extent. These “corrections” may be done as a minimally invasive laparoscopic procedure, which are safe and effective.

Additionally medication and hormone therapy are helpful in restoring the normal production of hormones and other substances like fluid and mucus, to regularise the normal reproductive health.

What are adhesions in the uterus? How do they affect fertility?

The presence of adhesions and/or fibrosis of the endometrium, generally linked to damage of the intrauterine cavity. This may affect hormone production, leading to disturbances in the normal fertility and ovulation cycle. The scarring may also prevent implantation or hinder the normal growth of the embryo.

What causes them?

Any trauma to the basal layer, for example during surgery for miscarriage, can lead to the development of scars resulting in adhesions in the uterus. In extreme cases, it may spread to the uterus ad tubes, making conception and pregnancy difficult.

What are the symptoms associated with it?

These conditions are usually asymptomatic and usually diagnosed when women are having a problem with conception. They sometimes may affect the menstrual cycle, and cause pelvic pain.

How are adhesions diagnosed?

  • Imaging - The detection of such abnormalities or conditions is usually done using imaging techniques like an ultrasound as that helps gain a detailed picture into the organs to detect problems if any.
     

 

How can they be treated?

Congenital defects or anatomical abnormalities are possible to correct in some cases depending on their extent. These “corrections” may be done as a minimally invasive laparoscopic procedure, which are safe and effective.

Additionally medication and hormone therapy are helpful in restoring the normal production of hormones and other substances like fluid and mucus, to regularise the normal reproductive health.

Wolfson Fertility Centre
Hammersmith Hospital
Du Cane Road
London W12 0HS
Private appointment/Enquiries:
0203 633 1885
email:
secretary@hammersmithivf.com
Platinum Medical Centre
Wellington Hospital
15-17 Lodge Road
St John's Wood
London NW8 7JA