Physical Abnormalities

Most of the physical abnormalities listed here are internal and may not be apparent to the average woman. They can prevent women in some way from getting pregnant. Structural problems in a woman's reproductive organs can be caused by a variety of factors, such as endometriosis, infection, congenital defects, inflammation, trauma, tumours and disease.

Endometriosis

Endometriosis occurs when tissue that normally grows in the uterus implants and grows in other locations. This extra tissue growth — and the surgical removal of it — can cause scarring, which impairs fertility. Researchers think that the excess tissue may also produce substances that interfere with conception.

The lining of the uterus is called the endometrium. Endometriosis refers to the build-up of endometrial tissue outside the uterus. Endometriosis can cause painful, heavy periods and pain during intercourse, but can also present no symptoms at all, except infertility.

Endometriosis can impact the ability to achieve pregnancy in different ways:

  • Adhesions may be produced that can trap the egg close to the ovary.
  • Endometriosis may reduce the mobility of the fallopian tube and prevent it from picking up the egg.

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Immune System

Normally, sperm and embryos are two foreign entities the female immune system will not attack. The immune system produces an allo-immune response to the embryo, effectively quarantining it in the uterus and protecting it from attack. However, in some cases, anti-sperm antibodies found in the cervical mucous of females can be responsible for the failure to conceive.

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Occluded Fallopian Tubes

Fallopian tubes play a crucial role in the female reproductive process, functioning as the pathway between the ovaries and the uterus. Tubal scarring or blockage can prevent the egg from reaching the uterus and prohibit the sperm from accessing the egg. Blockages in the fallopian tubes may be the result of a sexually transmitted infection (STI), scarring from pelvic surgery or pelvic inflammatory disease (PID), or from endometriosis.

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Ovarian Scarring

Scarring of the ovaries can trap the eggs inside the ovary. Ovarian scarring can be the result of PID or other infection, endometriosis or surgery. If the scarring causes the ovaries to be oddly placed, it might be hard for the fimbriae (finger-like projections at the end of the fallopian tubes) to gather the released eggs and move them into the fallopian tubes. The medical term for scarring is “adhesion”.

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Uterine Abnormalities

Abnormalities in the shape or position of the uterus may prevent fertilization, and may also prevent the ability for an embryo to implant or for the pregnancy to carry to term.

Abnormalities may include:

  • Malposition: The uterus may be sinking into the vaginal canal (prolapsed).
  • Growths: Fibroid tumors (benign growths that form on the uterus wall) and polyps (bunched up endometrial tissue) can impair fertility.
  • Bicornuate uterus: The uterus is divided into two chambers, divided by a septum (wall of tissue).
  • Unicornuate uterus: The uterus is one-sided.
  • Scarring: Can disrupt implantation.

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