Understanding Infertility

Uterine Infertility

Abnormalities of the endometrium (uterine lining) or of the uterus can contribute to infertility and/or recurrent miscarriage.

• Endometrial polyps are an overgrowth of the lining of the uterus. Fibroids are benign tumors of the uterine wall. Both polyps and fibroids, when located within the cavity of the uterus, could inhibit a healthy pregnancy from implanting or developing normally.
• Scar tissue inside the uterine cavity, also known as intrauterine adhesions or Asherman’s syndrome, can interfere with conception or increase the risk of miscarriage.
• Congenital problems such as an abnormally-shaped uterus, or the presence of a septum (a fibrous wall that divides the uterine cavity) can also contribute to difficulties initiating or maintaining a pregnancy.

Uterine abnormalities can be diagnosed by pelvic ultrasound, hysterosonogram, or hysterosalpingogram. A hysterosalpingogram is an X-ray test that evaluates the shape of the uterine cavity and determines whether both fallopian tubes are open. A hysterosonogram is a ultrasound test in which saline is infused into the uterus in order to visualize the uterine walls and cavity.

Polyps, fibroids, intrauterine adhesions, and uterine septa can often be removed by a minor surgical procedure. During a hysteroscopy, a thin camera is placed through the cervix into the cavity of the uterus, and small instruments are used to remove any intrauterine lesions.