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

Cesarean section scars can also pose a risk for subsequent pregnancies and births. After a cesarean section, the uterus is closed with a suture, and sometimes the area does not heal completely smoothly, leaving a pocket or indentation. In most cases, these pockets do not cause any symptoms and do not require treatment. However, they can sometimes cause symptoms such as spotting after your period or pain. If you are unable to conceive after a cesarean section, NICHE should be included in the assessment.

In rare cases, the uterus can tear during a subsequent normal delivery (uterine rupture). Sometimes, in pregnancies following a cesarean section, the placenta grows in the lower part of the uterus, blocking the natural birth canal (placenta previa). Risks are particularly significant if a woman becomes pregnant again very soon after a cesarean section. We recommend waiting at least one year before becoming pregnant again after a cesarean section. In cases of artificial insemination, we recommend inserting only one embryo into the uterus after a cesarean section to minimize the risk of rupture.
Contrary to the widespread belief that “once a cesarean, always a cesarean,” a woman can still give birth normally after a cesarean 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.