Uterine Factor Infertility
Once an egg is fertilized and becomes an embryo it implants in the lining of the uterus (endometrium). The uterus expands to accommodate the growth of a developing fetus and it must be free of serious defects.
Fibroids, also known as fibromyomas, leiomyomas or myomas, are non cancerous tumors that are outgrowths of the muscular wall of the uterus. Many times these tumors produce no symptoms and are discovered when the patient undergoes a hysterosalpingogram or sonohysterogram. Fibroids can become large enough to obstruct the uterus thus interfering with embryo implantation and the ability to carry a child to term.
Polyps are caused by an overgrowth of the tissue lining the uterus (endometrium). Many times polyps are small and do not interfere with embryo development. When they enlarge they can restrict the uterine cavity impairing implantation and development.
Some women are born with congenital abnormalities of the uterus such as the septate or bicornuate (two-horned) uterus which is heart shaped and divided into two cavities. Pregnancy can occur in many of these women; however, the miscarriage rate is much higher if a septum is present.
Many times a skilled reproductive surgeon can surgically remove polyps and fibroids causing only minimal scarring. Sometimes congenital abnormalities can be corrected by surgically reshaping the uterus.
When there is severe uterine damage the only alternative for creating a genetically related child is to use a surrogate mother. The infertile couple undergoes an IVF cycle and the resultant embryo is implanted in the surrogate who carries and delivers the baby.