Organic malformations/blocked fallopian tubes

Organic malformations

Anomalies in the womb (uterus) can lead to severe fertility problems and/or premature births or miscarriages.

Common uterine malformations are

  • the divided uterus (uterus septus)
  • two-part uterus (uterus bicornis) as well as
  • a uterus which only consists of one part (uterus unicornis)

The uterine septum is made up of connective tissue or muscle tissue, it often only partially divides the uterine cavity. Sometimes (very rarely) it completely separates the halves of the uterus.

Asherman Syndrome causes the uterine cavity to become closed by adhesions. The syndrome often arises after curettage or infections. After birth, the uterus lining is particularly sensitive. Therefore, placenta residues should be removed very carefully. Curettages, which take large parts of the uterine lining away with them, can result in serious complications for future pregnancies. Unfortunately, women with complete Asherman Syndrome are mostly sterile and menstrual periods are completely absent. But there are also mild forms in which the uterine cavity is not completely fused, and the woman still has light bleeding.

Scars

Caesarean scars can also pose a risk to later pregnancies and childbirths. In rare cases, the uterus may tear (uterine rupture) during a later normal birth. Sometimes the placenta grows in the lower part of the uterus after a caesarean section, so it blocks the natural birth canal (placenta previa). Risks are significant if a woman becomes pregnant again very shortly after a caesarean section. We recommend waiting at least a year after having a caesarean section before conceiving again. In the case of artificial insemination, we recommend inserting only one embryo into the uterus after caesarean sections in order to minimise the risk of rupture. Contrary to the widespread opinion ‘once a caesarean section, always a caesarean section’, a woman can give birth vaginally after having a caesarean section.

Blocked fallopian tubes

Blocked or damaged fallopian tubes are among the most common causes of infertility. The fallopian tubes connect the ovaries to the uterus and are where the egg is fertilized by the sperm. If they are completely or partially blocked, the egg cannot reach the uterus and natural pregnancy cannot occur.

Causes of fallopian tube blockages can include inflammation in the pelvic area, endometriosis, previous operations, or adhesions following infections. The condition often goes unnoticed for a long time and is only detected during fertility testing, for example, through a hysterosalpingography or laparoscopy.

Treatment depends on the extent and cause of the blockage. In some cases, surgical reopening of the fallopian tubes may be possible. However, in vitro fertilization (IVF) is often the appropriate treatment, as fertilization takes place outside the body and bypasses the fallopian tubes.