The uterine task is to implant the fertilized embryo in the endometrium and to provide embryonic and foetal development for nine months, and the birth. Uterine infertility can be congenital or obtained. It can affect the endometrium or myometrium and is the cause of infertility in 2-5% of cases.
Congenital defects of the uterus
- The relationship between congenital uterine development disorders and infertility is not entirely clear, except when the pathology is very serious.
- Adequate Millerian Duct formation during pregnancy provides anatomically normal development of the uterus, fallopian tubes, cervix and the upper third of the vagina. The full range of congenital or Millerian Duct abnormalities varies from a complete uterine and vaginal shortfall (Rokitansky-Kustner-Hauser syndrome) to minor defects, such as saddle-shaped uterus (uterus arcuatus) and bicornuate uterus.
- Unicornuate uterus (uterus unicornis) and uterus with a septum (uterus septatus) can have an increased risk of premature birth.
- Uterus with a septum can interfere with the implantation process and promote abortion in the first trimester.
Obtained defects of the uterus
- Uterine inflammation or endometritis (acute or chronic) may develop after traumatic childbirth, uterus cleaning due to miscarriage or a contraceptive in the uterine cavity (spiral).
- Adhesions in the uterine cavity may develop after any other type of procedure in the uterine cavity (myomectomy, hysteroscopy) and may contribute to the development of adhesions (Asherman’s syndrome).
- Placental polyp is the remnants of the placenta after abortion or childbirth.
A submucous myoma node occurs in 20-25% of women with fibromyoma and interferes with the implantation process, causing abortion in the first trimester of pregnancy, premature birth and premature detachment of the placenta.