Skip to main content Accessibility help
×
Hostname: page-component-7d684dbfc8-kpkbf Total loading time: 0 Render date: 2023-09-26T13:50:23.898Z Has data issue: false Feature Flags: { "corePageComponentGetUserInfoFromSharedSession": true, "coreDisableEcommerce": false, "coreDisableSocialShare": false, "coreDisableEcommerceForArticlePurchase": false, "coreDisableEcommerceForBookPurchase": false, "coreDisableEcommerceForElementPurchase": false, "coreUseNewShare": true, "useRatesEcommerce": true } hasContentIssue false

6 - Uterine factors in infertility

Published online by Cambridge University Press:  05 June 2014

Srividya Seshadri
Affiliation:
Guy's Hospital
Yacoub Khalaf
Affiliation:
Guy's Hospital
Siladitya Bhattacharya
Affiliation:
University of Aberdeen
Mark Hamilton
Affiliation:
Aberdeen Maternity Hospital
Get access

Summary

Introduction

Uterine factor infertility can be defined as the presence of structural or functional pathology in the uterus that can reduce fertility and diminish the chance of conceiving through assisted reproductive technology (ART) techniques. Embryo implantation, one of the most critical steps in ART, is a complex process that depends on the interplay between the embryo and the endometrium. Surgical management of uterine pathology could therefore be expected to influence the outcome of in vitro fertilisation (IVF) treatment. However, the literature in this regard is largely based on individual experience and observational studies rather than randomised controlled trials (RCTs).

Aetiology

The aetiology of uterine factor infertility can be broadly classified into two categories:

  1. • Congenital uterine anomalies result from a defect in the development or fusion of the paired müllerian ducts. Usually these abnormalities are mediated by a polygenic mechanism, although it is recognised that some occur sporadically.

  2. • Acquired uterine abnormalities include endometrial polyps, fibroids and adenomyosis. Intrauterine adhesions can occur after infections (commonly associated with endometrial curettage, such as following miscarriage or postpartum haemorrhage) or surgery (open or hysteroscopic myomectomy, resection of uterine septum and caesarean section).

Congenital uterine anomalies

The prevalence of congenital uterine anomalies is 6.7% in the general population and 7.3% in the infertile population. The most common anomaly is the septate uterus, with a prevalence of 3.9% in infertile women, followed by arcuate and bicornuate uteri. Women with septate uteri have reduced conception rates and increased risks of first-trimester miscarriage, preterm birth and malpresentation at delivery.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2014

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×