How Uterine Septum can cause Infertility in Women
In our Dallas area Fertility Center we commonly see women with infertility causes by structural abnormalities of the uterus, ovaries and abdominal cavity. One of the more common uterine abnormalities that DR. James Douglas’ sees is the uterine septum.
What causes a uterine septum?
The uterus in a female fetus forms from two separate halves that begin in the upper abdomen and travel downward as the fetus matures. The left and right sections of the uterus migrate down in the abdominal cavity and fuse together to create a hollow organ. As they fuse together the tissue in the middle, once the outer walls, reabsorbs to create the central cavity where the baby will grow. In some women this re-absorption of the middle wall is incomplete resulting in a thick band of remaining tissue, a uterine septum, in the middle of the cavity.
Uterine septums can be found in many different shapes and sizes. Some consist of a small tissue bands along the top of the uterus, while others deeply divide the uterus into two distinct segments, called a bicornuate uterus. Abnormalities in the structure of the uterus make it difficult for an embryo it implant in the uterine wall and grow.
Uterine septums are not normal uterine tissue. This abnormal tissue commonly has a very poor blood supply and therefore decreases the supply of nutrition to the implanting embryo resulting commonly in a loss of the pregnancy. Normal implantation of a fertilized embryo on the septum will greatly decrease the likelihood of a successful pregnancy is greatly decreased.
In most cases, unless the septum is so pronounced and extends into the vaginal canal most patients do not realize that that they have this condition and it is only discovered when the patient is examined for infertility, has repetitive miscarriages or is found during an annual PAP smear.
Treatments for Uterine Septum
In most cases a uterine septum can be corrected surgically by hysteroscopic resection. In the surgical repair of a uterine septum the additional tissue band is re-sected, or cut so that the entire top of the uterus enlarges, creating a more normal area for implantation to occur. Once this procedure has been performed, the uterus is much more capable of carrying a pregnancy to term.
Note: Uterine abnormalities other that septums are not usually repaired as the opportunity to increase the chance for pregnancy does not improve greatly with surgery.