Problems with the Womb
There are many reasons why the uterus (also known as the womb) may not provide the ideal receptive environment for an embryo to implant. The anatomy of the uterus is absolutely crucial to successful implantation. Disruption to this in the form of uterine anomalies are much more common in patients that struggle to conceive.
Uterine anomalies come in all different shapes and sizes. Patients can have two uteruses – didelphys uterus, a unicornuate uterus with just one fallopian tube or perhaps a septate uterus. And we see these much more commonly in patients with reproductive medicine difficulties.
Fibroids are a really important finding as well in our fertility patients. Fibroids come in all shapes and sizes and are throughout the uterine wall. Small fibroids are not always important and don’t always impact on implantation, but very large fibroids can interrupt the blood supply to the womb, and in some cases, depending on the exact location of those fibroids and the size of the fibroids, may impact on implantation.
Inside the uterus, polyps, can form. These are benign growths from the womb lining itself. They’re often identified in fertility patients and they can be a cause of difficulty with implantation. Polyps can be identified on ultrasound and if, seen are often removed as they may be impacting on that delicate interaction of the embryo with the wound cavity itself.
Under the influence of hormones, the womb lining, the endometrium changes throughout the menstrual cycle. During the luteal phase, after ovulation has occurred, the implantation windows open. As progesterone rises, the endometrial lining compacts and becomes ready for an embryo to implant.
It’s this successful interaction, which is absolutely critical. To a pregnancy beginning and to taking place without any difficulties.