IVF

The cervix and the uterus form an integral part of a woman’s reproductive system. Hence, they play an important role in the natural conception and a healthy pregnancy. But certain anatomical, congenital or other conditions affect their normal functioning, hence causing problems in fertility.

What kind of problems in the cervix causes infertility? What causes them?

The cervix has glands that secrete fluid, which serves as a media for sperm transport during fertilisation. Sperm is inserted into the vagina and swims in the cervical fluid through the cervix and into the uterus. It is rich in nutrients and has a particular consistency to support sperm transport. If the mucus lining the cervix is too “thick or sticky” it becomes a hurdle as the sperm is not able to reach the uterus.

Due to inherited malformation or damage to the cervix, the cervix may become narrow – this is called as Cervical stenosis. Sometimes the quality of the mucus produces, may not allow the sperm to travel through the cervix into the uterus.

Is there anything called as “sperm allergy”? What causes it?

Additionally, the cervical mucus must also be free of antisperm antibodies. This is a condition that causes “sperm allergy” in women. These antibodies are produced by the female’s immune system and recognise sperm as invading pathogens, such as virus or bacteria and seek to destroy them.

This causes the sperm to be rejected and prevents fertilisation.

What are symptoms of “sperm allergy”?

It may cause:

Redness and itching around the genital area after intercourse

Pain during penetrative sex

Can a woman having “sperm allergy” have become pregnant?

Couples suffering from this may be able to conceive via artificial insemination in which the sperm injected, is washed so that it is free from such proteins that set off the immune reaction in women. Other assisted reproduction techniques have shown a great success rate for such women, as there are no problems during pregnancy.

What Uterine Factors Can Cause Infertility?

  • Problems in the Uterine Lining
    For successful pregnancy, the embryo must travel and attach itself to the endometrial lining of the uterus. This lining must be thick and vascular so that it may supply nutrients to the embryo to support its growth. The development of the endometrium is dependent on the levels of Uterus progesterone and estrogen. Hence, when the development of the endometrium is not normal, enough progesterone is not produced to stimulate and support its growth.
  • Fibroids or Polyps
    Large polyps (abnormal growth) or fibroids in the uterus interfere with embryonic growth and development. Benign polyps or tumors (fibroids or myomas) are common in the women, and depending on their location and size, they can block fallopian tubes or become a hurdle in implantation.
  • Congenital Deformities and Malformations
    Uterine malformations and deformities cause problems with a woman′s ability to carry a pregnancy to full term. A commonly found one such condition is the T-shaped uterus. Women with such a uterus have an increased risk of miscarriages, preterm labour and delivery. Some women may be born with the uterus that is bicornuate, i.e. has two horns or other problems such as a uterine septum (scar tissue).

What are the symptoms of problems in the uterus?

Most of these conditions don’t show any symptoms and usually diagnosed when women are having a problem with conception. They sometimes may affect the menstrual cycle, and cause pelvic pain.

How are they diagnosed?

  • Imaging - The detection of such abnormalities or conditions is usually done using imaging techniques like an ultrasound as that helps gain a detailed picture into the organs to detect problems if any.
  • Genetic testing - helps determine whether a genetic defect causing infertility.
  • Hormone testing - To check levels of hormones that control or affect reproductive processes.

What is the treatment for such conditions affecting the uterus?

Congenital defects or anatomical abnormalities are possible to correct in some cases depending on their extent. These “corrections” may be done as a minimally invasive laparoscopic procedure, which are safe and effective.

Additionally medication and hormone therapy are helpful in restoring the normal production of hormones and other substances like fluid and mucus, to regularise the normal reproductive health.

What are fibroids or adhesions in the uterus? How do they affect fertility?

The Presence of adhesions and/or fibrosis of the endometrium, generally linked to damage of the intrauterine cavity. This may affect hormone production, leading to disturbances in the normal fertility and ovulation cycle. The scarring may also prevent implantation or hinder the normal growth of the embryo.

What causes them?

Any trauma to the basal layer, during a miscarriage, delivery or medical abortion, can lead to the development of scars resulting in adhesions in the uterus. In extreme cases, it may spread to the uterus ad tubes, making conception and pregnancy difficult.

What are the symptoms associated with it?

These conditions are usually asymptomatic and usually diagnosed when women are having a problem with conception. They sometimes may affect the menstrual cycle, and cause pelvic pain.

How are fibrosis and adhesions diagnosed?

  • Imaging - The detection of such abnormalities or conditions is usually done using imaging techniques like an ultrasound as that helps gain a detailed picture into the organs to detect problems if any.
  • Genetic testing - helps determine whether a genetic defect causing infertility.
  • Hormone testing - To check levels of hormones that control or affect reproductive processes.

How can they be treated?

Congenital defects or anatomical abnormalities are possible to correct in some cases depending on their extent. These “corrections” may be done as a minimally invasive laparoscopic procedure, which are safe and effective.

Additionally medication and hormone therapy are helpful in restoring the normal production of hormones and other substances like fluid and mucus, to regularise the normal reproductive health.

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