The uterus as a cause of implantation failure and repeated miscarriages
To achieve pregnancy naturally or through assisted reproduction treatments, a uterus in good reproductive condition plays a key role.
Infertility linked to uterus-related causes can occur either due to malformations in the anatomy of the uterus or due to the existence of different benign pathologies such as polyps, adenomyosis, myomas, adhesions, etc.
The uterus is a muscle that contains a cavity in the centre in the shape of an inverted triangle and is located in the female pelvis. It comprises three tissue layers.
Both uterine malformations and anomalies in any of its layers can be a cause of infertility.
Uterine pathology assessment
When treating uterine problems associated with infertility, diagnosis requires a comprehensive study of the uterus. Due to its morphology and changing nature throughout the menstrual cycle, the uterus can hide defects depending on when the examination is performed.
The uterus is a key organ for human reproduction, whether natural or through assisted reproduction treatment. The semen travels through the uterus to the fallopian tubes to fertilise the egg. Once fertilization has taken place (in the tubes), the embryo travels to the uterus to implant in its internal layer or endometrium, which will be responsible for providing optimal conditions to nourish the embryo and make it develop into a full-term pregnancy.
The main uterine pathologies such as congenital anomalies or malformations, the well-known endometrial polyps, myomas or uterine synechiae, can be the origin not only of infertility due to implantation failure, but also of repeated miscarriages and even premature or preterm deliveries.
Uterine pathology diagnosis
The most relevant medical procedures involved in diagnosing uterine pathologies are as follows:
Main uterine pathologies
The main non-cancerous uterine pathologies in women of reproductive age are:
- Uterine malformations
- Endometrial hyperplasia, endometrial polyps, endometrial polyps, myomas, endometritis
- Endometriosis of the uterine wall (adenomyosis)
- Intrauterine adhesions, Isthmocele, Asherman’s Syndrome
- Uterus morphology, such as retroversion and others
- Hydrosalpinx
- Cervicitis
- Abnormal uterine bleeding
Symptoms of problems in the uterus
Although the most common symptomatology such as bleeding usually leads us to uterine fibroids, there are times when patients do not experience any discomfort in this regard or it’s another type of pathology.
The most common symptoms of problems in the uterus are usually:
- Discomfort in the pelvic area
- Inability to urinate or constant need to urinate
- Gas and constipation
- Abdominal distension
- Very heavy and long-lasting menstruations
- Pain during intercourse
Diagnosis and treatment personalisation
The most relevant medical procedures involved in the diagnosis of uterine pathologies are the following:
At Equipo Juana Crespo, the study of the uterus is essential before considering any embryo transfer, whether from your own eggs or from a donor.
The 3D ultrasound performed on the first visit and the MRI are a regular part of our array of diagnostic tests. Based on the study and conclusions of these two tests, the specialist can continue to prescribe complementary diagnostic tests such as diagnostic hysteroscopy or establish a treatment strategy aimed at correcting uterine pathologies.
Types of treatment for uterine pathologies:
The Juana Crespo Team surgery unit performs these treatments. Generally after ovarian stimulation and always before endometrial preparation to ensure that the uterus is in perfect condition before embryo transfer.
Frequently Asked Questions
The medical procedures to be followed for a possible uterine problem are wide-ranging and depend on each patient’s clinical picture. To perform the appropriate diagnostic tests, it is necessary to visit the clinic, where one of our specialists will determine the procedures to be followed in each case.
The symptomatology associated with uterine problems are warning signs that the patient can observe, then request an appointment with her trusted gynaecologist. However, sometimes there are no specific symptoms, so in many cases the diagnosis is reached after an infertility appointment.
Next, based on the recommended medical procedures, a diagnosis is made to enable treatment for uterine problems.
Often, especially at older ages, infertility is not due to a single cause. In such cases it is essential, in addition to treating the uterus, to consider a strategy focused on the entire reproductive system.
However, we have many cases where, after uterine surgery, a natural pregnancy is achieved without the need for in vitro fertilization.
