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You are here: Home - Pregnancy - Pregnancy Complications

Reproductive Abnormalities Which May Impact Fertility

by Katrina Wharton | January 31, 2015 8:26 AM
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Most women don't know much about their reproductive organs unless they cause problems, either with pain or with trying to get pregnant. Many abnormalities can be so mild they don't cause any problems at all, while others may require surgery to address more serious issues. Here are some of the better known conditions and their outlook.

Retroverted or tilted uterus

While very few women know it, quite a few have a tilted uterus. In fact, one in four or five, depending on which statistics you believe. A typical uterus tips forward at the cervix. However, women with tilted uteruses have uteruses that lean backwards at the cervix.

Generally, women won't know they have a tilted uterus unless told by a physician after a gynecological exam. It's rare that one would cause any pain or problems. If the position is simply genetic, it won't cause problems getting pregnant. It is possible that if the tilt is caused by a problem, such as a tumor or endometriosis, it could be sharply tilted and cause some fertility issues.

Very rarely, in pregnancy a tilted uterus can become trapped, in a condition called uterine incarceration. This condition may be painful and inhibit urine passing.

After diagnosing with an ultrasound, easy techniques can usually right the uterus into the position it should be in. In most pregnancies however, the uterus is set right in the second trimester all by itself. Some cases of tilted uteruses are caused by fibroid tumors, or scar tissue.

Congenital uterine abnormalities

Approximately 3 percent of women are born with uterine abnormalities. Some of them include septate uterus, where it is divided into two sections by a band of muscle or tissue. This is the most common type of abnormality involving the uterus, and may cause problems such as miscarriage.

Other types include bicornate, where instead of having one cavity there are two which may be partially or completely joined. In didelphic or double uterus, there are two uteruses and two cervices. In unicornate uterus, the uterus is only a half uterus. These problems can be diagnosed through ultrasound, or a special ultrasound using salt water, or an x-ray using dye, or an MRI.

Many types may be successfully treated with surgery, but physicians usually only perform surgery if the woman has had a problem with getting or staying pregnant.

Acquired uterine abnormalities

These changes in the uterus occur due to later life events such as uterine adhesions or scars, or fibroids or other types of tumors.

Incompetent or short cervix

Some women suffer from incompetent cervix, which means the cervix will open early in pregnancy without pain or contractions resulting in either a late miscarriage or early labor. Some factors include uterine abnormalities, surgeries affecting the cervix, injuries to the cervix or injuries during a previous birth.

With a short cervix, you have a heightened risk of also having an incompetent cervix. Women with especially short cervices, those less than 15 millimeters, have a higher risk of preterm birth and some research indicates that progesterone cream can help prevent this from occurring.

Women with incompetent cervix will have a cerclage, or a sewing up of the cervix, in the pregnancy after it's diagnosed as being an eminent threat, usually through regular ultrasounds.

Fibroids

These are non-cancerous growths of muscle affecting between 20 to 40 percent of women in their childbearing years, typically during their 30s and 40s. Women may have no symptoms, or may have problems with heavy periods, painful intercourse, anemia, abdominal pain, backaches, problems urinating and frequent urination. These growths range from pea-sized to over 6 inches wide.

Fibroids may cause problems with pregnancy if they break down during the expectant months and cause pain or low grade fever. The treatment is bed rest and pain relievers.

Large fibroids may need surgical removal prior to pregnancy in some cases.

While most women with fibroids will have successful pregnancies, some may have difficulties such as miscarriage, preterm labor, breech babies, placental abruption, heavy bleeding post-birth and increased risk of c-section usually due to baby being breech.


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