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.

What are uterine abnormalities and cervical abnormalities?

The cervix is a tunnel-like organ connecting the vagina and the uterus (womb). For fertilization to occur, sperm must travel from the vagina through the cervix, then through the uterus and into the fallopian tube where fertilization of an egg occurs. Abnormalities in either organ can disrupt this process.

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.

Symptoms of these abnormalities

Both abnormalities can present similar symptoms or no symptoms at all. Symptoms common to uterine and cervical anomalies may present as:

  • Abnormal bleeding such as heavy flow during periods, bleeding between periods and bleeding after sex.
  • Vaginal discharge of an abnormal nature, which may have an unpleasant odor.
  • Difficulty conceiving, which is often a reason patients come to us for care.
  • Recurrent miscarriage.
  • Pelvic discomfort and pain, including pain with sex.
  • Altered cervix appearance with abnormal texture or color, as well as lesions.

Such signs are not always indications of cervical or uterine anomalies.

Infertility treatments for abnormalities of the uterus and cervix

For women and couples experiencing trouble conceiving due to these issues, infertility treatments performed by a fertility specialist offer a means of achieving a successful pregnancy. Factors such as the specific type of abnormality, personal medical history and fertility potential of the patient(s) play a role in creating the most effective treatment plan. Our fertility specialist discusses treatment options with each couple or individual, ensuring a comprehensive understanding of options and strategies.

Intrauterine insemination (IUI)

This places sperm in the uterus. IUI is mainly an option for bypassing cervical abnormalities.

In vitro fertilization (IVF)

IVF, which involves fertilization and embryo development in the lab, can be used to bypass anomalies in the cervix and uterus, though not all uterine anomalies.


Surgery can correct anomalies in the uterus and cervix, enabling pregnancy. This includes septate uterus and bicornuate uterus, as well as uterine fibroids and polyps. Surgery also addresses cervical stenosis and can remove cervical polyps impeding sperm movement.

Fertility medications

Fertility medications can sometimes treat endometrial hyperplasia in the lining of the uterus (endometrium). Hormone medications may also improve the quality of cervical mucus. Antibiotics can treat cervical and uterine infections that may cause anomalies.


Related reading: Treatment FAQ