Abnormalities of the uterus can cause infertility by interfering with embryo implantation and fetal growth. Uterine factor infertility is relatively uncommon occurring in less than 5 percent of women.
At Footsteps to Fertility Centre, we have been helping women with uterine abnormalities bring home healthy babies. Our fertility center is home to experienced and compassionate physicians.
Sometimes, an abnormality of the uterus happens before birth. Like other organs in the body, a woman’s reproductive organs form with she is still a fetus inside her mother’s uterus.
The reproductive organs include the uterus and fallopian tubes. Sometimes the uterus and fallopian tubes may not form as they should.
These malformations are called mullerian anomalies. There are many types of mullerian anomalies, including failure for the uterus or tubes to form (agenesis), a complete duplication of the uterus, cervix, and vagina (didelphys), two uteri sharing a single cervix and vagina (bicornuate), a single uterus with a fibrous band going down the center of the uterus (septate), and normal uterus with an incidental dent in it (arcuate).
The inner part of uterus where the embryo implants is called the endometrial cavity, which is surrounded by the muscle layer of the uterus.
If there are problems associated with the uterus or the endometrial cavity such as congenital anomalies, scar tissue, endometrial polyps or fibroids, implantation may be compromised.
If there is a pathology associated with the uterus, it needs to be treated and the uterine cavity assessed prior to starting infertility treatment.
Our multidisciplinary team offers the advanced level of comprehensive care needed to manage uterine abnormalities.
Uterine abnormalities interfere with egg fertilization or embryo development and often include:
The endometrial lining is routinely measured using vaginal ultrasound in IVF cycles and is expected to be of adequate thickness for embryo implantation.
An endometrial thickness of 8 mm or greater is generally considered adequate thickness and less than 7 mm has been associated with lower pregnancy rates, with almost no pregnancies observed with a lining less than 5 mm.
Poor endometrial lining most commonly occurs in women with a history of unexplained recurrent IVF failures or early recurrent miscarriages.
The poor endometrial lining is attributable to the following factors:
- Endometritis: Chronic infection of the endometrial cells.
- Fibroids of the uterine wall (non-cancerous muscle tumors of the uterus).
- Women using clomiphene citrate (Clomid, Serophene).
- Scar tissue of the endometrium (Intrauterine adhesions also known as Asherman’s syndrome).
- Distal tubal blockage (hydrosalpinx) and leakage of toxic fluid back into the uterus.
- Intrauterine adhesions
- Long-term use of birth control pills
- Issues pertaining to infertility
- Abnormal or irregular menstrual cycle
- Irregular or Painful Menses
During an IVF cycle, when the endometrial lining is observed, additional estrogen in the form of vaginal suppositories may improve the overall endometrial thickness and outcome.
Some investigators have used baby aspirin to improve the outcome, but results have been quite variable and most likely there is no benefit.
Sildenafil (Viagra) is a commonly used drug for erections problems in males and has been shown to increase penile blood flow. Investigators have used Viagra to increase the blood flow to the uterus with the hope of delivering more estrogen hormone to the uterine lining.
Viagra vaginal suppositories can be used to achieve this goal in IVF cycles, in which the endometrial lining is thin despite additional vaginal estrogen treatment. In most cases of thin lining, the underlying cause can be identified and treated without the need for additional intervention.
If women are grappling with issues related to pregnancy, like being unable to get pregnant or having difficulty in holding pregnancy, they must get their estrogen level and thickness of Endometrium checked.
Uterine Lining must be at least 8 mm thick for successful implantation of the fetus. If it is thin, implantation does not take place which culminates in the failure of pregnancy. Hence one needs to get treatment for thin endometrium to become pregnant.