Uterine Abnormalities, Cervical Abnormalities & Fertility

Cervical & uterine abnormalities overview

• Cervical and uterine abnormalities are conditions that can significantly challenge women’s reproductive health, often interfering with fertility and causing complications during pregnancy.
• These abnormalities can be congenital (occurring before birth), such as a misshapen uterus, or the result of an acquired condition, such as infections.
• Both conditions affect fertility by restricting the free movement of sperm through the cervix and uterus to the fallopian tubes for fertilization.
• Symptoms can include abnormal bleeding, discomfort and pain, abnormal vaginal discharge, problems conceiving and changes in the cervix’s appearance.
• Our fertility specialist generally diagnoses these conditions through combinations of examination, medical history, lab tests of hormones and various imaging tests.

Uterine abnormalities

Uterine abnormalities (also known as anomalies) refer to structural defects in the uterus, which are congenital or acquired later in life. The uterus plays a pivotal role in successful pregnancy, making abnormalities problematic.

Congenital uterine anomalies are estimated to affect less than 5% of women. Types include:

• Septate uterus, which is a wall of tissue creating two cavities.
• Unicornuate uterus has only one fallopian tube instead of two and is smaller than normal.
• Didelphys uterus is a rare condition where the woman is born with two uteruses.
• Bicornuate (double) uterus has an abnormal heart shape and is also rare.

Each variant carries distinct fertility and pregnancy implications. For instance, a septate uterus, the most common type, can lead to recurrent miscarriages due to the fibrous or muscular septum that interferes with embryo implantation.

Uterine fibroids, which are noncancerous growths of the uterus, are another common issue affecting many women often causing fertility issues and pregnancy complications. Uterine polyps of the uterine lining can prevent embryo implantation.

Cervical abnormalities

Cervical abnormalities can also be congenital or form during life. Cervical stenosis is a narrowing of the cervical opening, which can prevent sperm from passing through. Cervical stenosis affecting fertility most often is congenital, though women in older years can develop it.

Cervical polyps can rarely become large enough to block the canal. This can lead to female infertility.

Problems with cervical mucus, a natural discharge, can hamper the movement of sperm and even kill or damage sperm cells. Cervical mucus issues can affect fertility but rarely are the sole cause of female infertility.

Understanding these two abnormalities is crucial for effective diagnosis and treatment.

What causes cervical & uterine abnormalities?

Many, particularly uterine anomalies, are caused before birth by malformations during embryonic development. These are due to genetic factors.

Acquired uterine abnormalities typically result from infections, such as sexually transmitted infections. Injury or previous procedures such as dilatation and curettage can cause issues. These include Asherman’s syndrome, characterized by intrauterine adhesions or scar tissue that can block or distort the uterine cavity, potentially causing infertility, recurrent miscarriages or problems in fetal development.

Hormonal imbalances can affect cervical mucus and the uterine lining. Polycystic ovary syndrome (PCOS) can cause uterine abnormalities.