When there are abnormalities of the uterus, a woman can be diagnosed with uterine factor infertility, which can significantly impact the ability to conceive and carry a successful pregnancy. Uterine factor infertility is a general term that encompasses many scenarios that could cause the inability to conceive. Women may develop a uterine problem due to a surgery or past infection, while others have an abnormally developed uterus from birth, known as congenital uterine factor infertility.
Congenital Uterine Factor Infertility
The Mullerian ducts are the predecessors to the female reproductive system, forming at about 10 weeks. When they do not fuse properly, it leads to malformation of the uterus and other reproductive organs. Congenital abnormalities are sometimes known as Mullerian anomalies.
Types of Mullerian anomalies may include:
- Duplicated parts of the reproductive system
- Unusual uterus shape
- Indentation in the uterus
- An entirely duplicated reproductive system
- Uterus or fallopian tubes that do not form completely
- Uterus with a fibrous band dividing it
- The absence of a uterus
When a congenital uterine factor is suspected, a hysterosalpingogram (HSG) test may be performed to help in diagnosis. A sonohysterogram is another option, in which a small amount of sterile water or saline is injected and the uterus is examined by a transvaginal ultrasound. This technique allows the physician to view separate uterine cavities, and they may be able to see if the uterine abnormality is from a septate uterus or a bicornuate uterus.
If a woman is diagnosed with a septate or bicornuate uterus, a metroplasty, or surgical correction of the uterus, is often recommended. If the surgeon is not confident in the diagnosis, a laparoscopy should be performed in order to confirm. The septum can usually be removed by hysteroscopy during a septate uterus correction surgery while the patient is under anesthesia.
In the case of a septate uterus, a woman can typically begin trying to get pregnant soon after surgery. The woman is allowed to have a normal labor and vaginal delivery. After surgery for a bicornuate uterus, patients are recommended to wait at least three months before attempting to conceive, and a cesarean section is often recommended for delivery due to increased risk of uterine rupture during labor.
The North Carolina Center for Reproductive Medicine/Talbert Fertility Institute is the premiere center for reproductive health in North Carolina and the East Coast. Our team specializes in fertility testing, diagnosis, and treatment of infertility conditions. We’re experts in IVF, Tubal Ligation Reversal, Male Infertility, Intrauterine Insemination (IUI), Gestation Surrogacy, Family Balancing, and more. Contact us today.