Obstruction or malfunction of the tubes, endometriosis, polyps and uterine fibroids, structural malformations of the uterus. Let’s see what these disorders consist of and why they affect the fertility of women.
There are certain defects of the female genital apparatus that can make it difficult, and even impossible, to conceive a baby naturally. In fact, among the main causes of infertility in women, we find obstruction or malfunction of the tubes, endometriosis, polyps and uterine fibroids, and structural malformations of the uterus. These defects can be detected in the gynaecological consultation, through the appropriate controls.
Thanks to specific tests, such as hysterosalpingography (HSG) and laparoscopy, the Gynaecologist can find out if a woman’s tubes are open and healthy. The first test is done by injecting a liquid solution into the uterus through the vagina; Afterwards, x-rays are taken to observe the passage of the liquid through the tubes and, thus, check that they are open. Laparoscopy, on the other hand, is a more invasive examination, which involves inserting very fine surgical tools into the abdomen, making small holes. This examination is more precise because it not only allows better observation of the area but also gives the possibility, if necessary, to directly operate on possible anomalies (such as polyps and fibroids). If the tubes are closed or malfunctioning, it will be decided, together with the doctor, if it is better to solve the problem by means of a surgical operation or it is preferable to opt for IVF.
In some women, the mucosa that lines the inside of the uterus may develop abnormally and also grow in areas outside the uterus (such as the ovaries and bladder). Excess tissue can create adhesions and cysts, and hinder conception. To diagnose endometriosis, it is sufficient to have a check-up and ultrasound, but, in most cases, laparoscopy is also necessary. To treat it, you have to take medications and intervene surgically, in order to remove the excess tissue.
Polycystic Ovary Syndrome (PCOS)
Polycystic Ovary Syndrome occurs when the female ovaries or adrenal glands produce more male hormones than normal. This causes growth of cysts (fluid-filled cavities) in the ovaries. Symptoms include:
- Irregular menses
- Pelvic pain
- Excess hair on the face, chest, abdomen, or thighs
- Weight gain
- Acne or oily skin
- Thick brown or black leather patches
Polyps and Fibroids
The formation of some growths, called polyps, on the lining of the uterus, can reduce a woman’s fertility. If the polyps are very large, they can cause irregularities of the menstrual cycle and losses between menstruations. Fibroids, on the other hand, are benign tumours of the uterus that can have different measures (from very small to very large). When detected (with ultrasound or laparoscopy), polyps and fibroids can be removed through surgery.
Malformations of the Uterus
Although it doesn’t happen very often, some structural abnormalities of the uterus can cause infertility or recurrent miscarriages. In fact, in some women, the uterus may have a different structure, which can make it difficult to conceive or to progress correctly during pregnancy. The uterus, for example, can be septum (when it is totally or partially divided into two parts by a fibrous wall) or bicornuate (if the upper part is divided into two parts). If these abnormalities reduce fertility, surgical intervention may be required.