Causes of infertility - defects in the uterine cavity

Abnormalities of the uterine cavity are found in approximately 6% patients of infertility clinics. The uterine factor in female infertility includes structural abnormalities of the uterus and changes that occur in this organ and make it difficult to become pregnant or to carry a pregnancy. Most disorders can be diagnosed and treated in primary care.

Congenital abnormalities of the uterus, such as a double, unicornuate or bicornuate uterus, usually do not affect the fertilisation of the egg and implantation of the embryo in the uterine cavity, but can make it difficult to carry a pregnancy to term. The problem of infertility is most often related to the presence of a septum in the uterus - this disorder is diagnosed during an ultrasound or Sono HSG and is finally diagnosed after a hysteroscopic examination, during which the doctor can remove the septum that prevents pregnancy. Once the uterine septum is removed, the healing time is between two and five months, depending on the surgical technique used and the extent of the procedure. Patients usually regain full fertility.

Uterine malformation (so-called Meyer-Rokitansky-Kustner syndrome) and hypoplasia (underdevelopment) of the uterus are congenital structural defects that can only be treated by uterine transplantation. This method of treatment is not available in Poland.

Infertility in women can also result from the presence of acquired defects such as multiple adhesions of the endometrium (Asherman syndrome), submucous myomas (myomas that grow into the uterine cavity) and endometrial polyps. Lesions of this type are diagnosed during ultrasound examination and the final diagnosis is made during hysteroscopy. In the treatment of acquired uterine defects, surgical hysteroscopy is used to restore full fertility. If the patient has small (no more than 4 cm) intramural and subserosal myomas that develop outside the uterine cavity and do not distort the uterus and therefore do not affect the process of conception and the course of pregnancy, it is not necessary to undertake treatment.