The uterus must be normally shaped and free of large obstructions in order to support a developing fetus. The uterus is lined with endometrial cells that rapidly divide, under the influence of estrogen and progesterone, during the ovulatory cycle. This cell division increases the width and vascularity of the uterus preparing it to nourish the embryo and later the fetus.
Some women are born with congenital abnormalities of the uterus including conditions such as the unicornuate uterus (half uterus) and uterine septum (vertical barrier inside uterus).
A uterine septum may cause repeat miscarriages if the embryo implants on the septum. Uterine abnormalities can be diagnosed by
hysterosalpingogram,
ultrasound, sonohystogram, MRI, or hysteroscopy with
laparoscopy.
At the time of hysteroscopy, a reproductive endocrinologist can cut a uterine septum and reduce the repeat miscarriage tendency. If other uterine abnormalities such as a unicornuate uterus are diagnosed, your physician may choose to replace fewer embryos at the time of IVF, for example, because the size of the uterine cavity is smaller.
Large polyps, fibroids, or scar tissue may also obstruct the uterus. In most instances, times these conditions can be corrected by
hysteroscopic surgery. Reproductive endocrinologists at UAB have expertise in correcting these conditions.