Uterine Disease

The uterus must be free of obstructions to properly prepare to support the growth of an embryo. Women with uterine disease often have obstructions and/or abnormalities that interfere with the embryo’s implantation and growth. Some obstructions, like fibroids and tumours, can be removed laparoscopically or by hysteroscopy. Other abnormalities can be corrected surgically. Pelvic infections, if caught early and treated with antibiotics, can limit damage to the uterus and other reproductive organs. However, serious infections can leave the uterus and fallopian tubes permanently scarred.

What are my options if my uterus is severely damaged?

Your only option is to use a gestational carrier, a woman who carries your embryos, produced by an IVF cycle, to term. The child is genetically related to both parents.

How does the uterus work?

The uterus is a muscular organ that accepts the embryo and expands to support the growth of the fetus. The embryo implants in the uterine lining or endometrium. During the ovulatory cycle, the endometrium thickens and becomes more vascular under the influence of progesterone. This growth can be measured via transvaginal ultrasound. Increased blood flow is needed to support the growth of the embryo.

My X-ray or ultrasound shows fibroids in my uterus. Will this affect my chances of getting pregnant?

Fibroids can have a negative impact on pregnancy success, but not always. The two most important issues in relation to fibroids and pregnancy are the size of the fibroids, and their location within the uterus. It is well documented that fibroids that are inside the uterine cavity need to be removed prior to fertility treatments. Fibroids that are attached to the outside of the uterus often have no impact on the chances of becoming pregnant. Fibroids that are in the muscle of the uterus have a less defined impact on fertility success. If they are pushing into the uterine cavity, they should probably be removed. Many fertility specialists believe if these fibroids do not push into the cavity, but are numerous, or large (5 cm or greater), they should also be removed. Fibroids may be removed a number of ways. If they are in the uterine cavity, they may be removed by a procedure called hysteroscopy. This is a safe day surgery procedure. If the fibroids are within the muscle of the uterus, they can sometimes be removed by laparoscopy (day surgery), but often this procedure is performed by a mini-laparotomy (5-6 cm bikini line incision), that requires a 1-2 day hospital stay. My X-ray shows a polyp in my uterus.

What does this mean?

Uterine (or endometrial) polyp is a benign growth of the lining of the uterus. These should be removed by hysteroscopy prior to embarking on fertility treatment. The hysteroscopy procedure is a day procedure with a same day recovery time.

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