Causes of infertility – defects in the uterine cavity
Abnormalities within the uterine cavity are found in about 6% of patients of infertility treatment clinics. The uterine factor in female infertility includes morphological defects of the uterus and lesions that appear in this organ and make it difficult to get pregnant or to carry pregnancy to full term. Most disorders can be diagnosed and treated in primary care.
Congenital defects of the uterus, such as uterus didelphys, unicornate or bicornate uterus usually do not affect egg cell fertilization and embryo implantation in the uterine cavity, but can make it difficult to carry the pregnancy to the full term. The infertility problem is most often related to the presence of a septum in the uterus - this disorder is diagnosed during an ultrasound or Sono HSG examination and is eventually diagnosed after a hysteroscopic examination, during which the physician can remove the septum that prevents pregnancy. After the removal of the uterine septum, the healing time is two to five months, depending on the surgical technique used and the extent of the procedure. The patients usually regain full fertility.
Uterine aplasia (so-called Meyer-Rokitansky-Kustner syndrome) and hypoplasia (underdevelopment) of the uterus are congenital morphological defects that can only be treated by means of uterine transplantation. This treatment method is not available in Poland.
Female infertility can also result from the presence of acquired defects such as multiple adhesions of the uterine mucosa (Asherman's syndrome), submucosal fibroids (fibroids that grow into the uterine cavity) and endometrial polyps. Such lesions are diagnosed during ultrasound and the final diagnosis takes place during hysteroscopy. In the treatment of acquired uterine defects, surgical hysteroscopy is used to restore full fertility. If the patient has small intramural and subserous fibroids (of no more than 4 cm), which develop outside the uterine cavity and do not deform it, and therefore do not affect the process of fertilization and the course of pregnancy, it is not necessary to undertake any treatment.