UNDERSTANDING WHAT IT MEANS TO HAVE A BLOCKED WOMB

If a fallopian tube is blocked, the passage for sperm to get to the eggs, as well as the path back to the uterus for the fertilized egg, is blocked. Common reasons for blocked fallopian tubes include #DcarTissue, #infection, and #pelvic adhesions.

blocked #allopian tube may cause some women to experience symptoms such as pain in the pelvis or belly. This pain might happen regularly, such as around the time of their period, or be constant. Sometimes, a blockage in a #FallopianTube can cause a #FertilizedEgg to get stuck. This is known as an ectopic #pregnancy.

Yes, a woman can still ovulate if she has a blockage in her tube(s). However, the obstruction in the passage of the oocyte might cause ectopic pregnancy or infertility. Do women with blocked #FallopianTubes still #menstruate? Yes, women with a #FlockedFallopian tube can still #menstruate.

In handling infertility issues, one recent challenge we have had to contend with from couples who visit us in the office, is the issue of blocked womb. I don’t mean blocked fallopian tube. So, can a womb truly be blocked?

What is the cause of a womb block?

The womb/uterus is seldom blocked; the womb often refers to the uterus. Blockage can occur when there had been excessive scarring.

What is Uterine Scarring?

Intrauterine adhesions, also known as synechiae or scar tissue, are bands of fibrous scar tissue that form within the uterus. Scar tissue affects the functional lining of the #uterus and can be a reason for #infertility.
Your uterus has three layers: an outer layer ( #serosa ), a middle muscular layer ( #myometrium ), and an inner layer ( #endometrium ). The inner layer contains the lining that sheds once a month with a woman’s menses. It is also the place where an embryo implants and grows into a pregnancy.
Uterine scarring is caused by trauma to the lining with a procedure and/or inflammation. Rates of scarring are highest when there is a uterine procedure done in the setting of an infection. Potential causes for scarring include:
Surgical:
• Dilation and curettage for prior abortion, miscarriage, retained placenta after delivery, abnormal uterine bleeding
• Cesarean section
• Myomectomy
Inflammation/infection:
• Endometritis – infection of uterine cavity
• Other infections (Chlamydia, Tuberculosis, Schistosomiasis)

#Symptoms:
Uterine scarring that causes symptoms is called Asherman Syndrome. Symptoms might include a lighter period, “hypomenorrhea” or no period, “amenorrhea”. Scar tissue can cause cyclic pelvic pain from menstrual blood getting trapped in the uterus. It can also cause recurrent pregnancy loss or an inability to conceive.

How does it cause infertility?

Uterine scarring decreases the ability to get pregnant because it decreases the blood supply to the endometrial lining. It may also cause the cavity to be completely scarred. A healthy endometrium is important for an embryo to implant. Scar tissue can also be a physical barrier for sperm to enter the upper uterus to fertilize an ovulated egg.

Workup:
Uterine scarring can be seen on imaging such as hysterosalpingogram which is an X-ray of the pelvis, pelvic ultrasound, and saline sonogram which a ultrasound with sterile water. It is best assessed with hysteroscopy, which is a surgical procedure where a camera used to look inside the uterus.

#Treatment:
The treatment for #uterine scarring is removal of scar tissue at the time of #hysteroscopy. After the procedure, a balloon catheter is typically placed inside the uterus for a short time and estrogen therapy is given to decrease scar reformation. Recurrence rates can be up to 33% in mild to moderate adhesions and 66% in severe adhesions. This procedure should be performed by an experienced surgeon or fertility specialist. Successful treatment can lead to pregnancy, with previously reported rates of 40-80% and live birth rates of 30-70%.

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