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Causes of infertility

Uterine problems

Many women who have uterine problems may have no problems getting pregnant, but they may have difficulty in keeping the pregnancy as they tend to miscarry. Most women have no symptoms, some women will have scanty periods, and if the woman has no uterus she will have no periods, (but remember there are many causes of absent periods). Some patients may also complain of heavy periods (due to fibroids).

Incidence

2-5%

Causes

Fibroids

Fibroids are benign growths of the muscle of the womb; they are very common especially in older women. Many women who have fibroids are fertile and have no problems with keeping the pregnancy. However, if the fibroid significantly distorts the cavity of the womb, it may interfere with embryo implantation. Also fibroids can displace the Fallopian tubes and ovaries.

Uterine Polyps

Uterine polyps, these are very common small growths dangling in the cavity of the womb. They can interfere with conception by acting like a coil.

Hysteroscopic view of an endometrial polyp.

Adhesions in the uterine cavity (cavity of the womb) may be a consequence of infection or surgery such as D&C (scraping of the uterus).

Intrauterine adhesions

Intrauterine adhesions (Asherman’s Syndrome) scar tissue inside the uterine cavity, this can cause absent periods, interfere with conception, and can increase the risk of miscarriage.

Endometrial lining

Both too thin and too thick an endometrium could reduce the chance of conception. In general 8-12 mm endometrial thickness is good when measured by ultrasound scan around day 10-12 of the cycle.

Congenital Problems

Congenital problems (problems from birth) e.g. absent uterus, the uterus has not developed sufficiently in size (hypoplastic uterus). Abnormally shaped uterus such as T shaped uterus, double uterus, birconuate (two-horned uterus), unicornuate (a half uterus) and uterine septum (this is the most common congenital abnormalities and is associated with the highest incidence of reproductive failure such as recurrent miscarriage).

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Last updated: Tue, 15 Apr 2008 - 7:41:53
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