Female Infertility

Several factors can contribute to female infertility, including anovulation, tubal  and cervical-uterine issues.

Tubal Factor

The cervix is located in the lower part of the uterus. Conditions of the cervix can affect fertility but are rarely the sole cause of infertility. The following can contribute to cervical health:

  • Abnormal pap smear(s)
  • Prior cervical biopsies
  • Cervical surgery (cone biopsy)
  • “Freezing” and/or laser treatment of the cervix
  • The patient’s mother took DES (diethylstilbestrol) while she was pregnant

Cervical problems are generally treated with antibiotics, fertility medications or by intrauterine inseminations (IUI).

The uterus (womb) is where the fertilized egg implants and develops. Uterine abnormalities can account for 20 percent of female infertility and include:

  • Uterine scar tissue (Asherman’s Syndrome)
  • Polyps (bunched-up pieces of the endometrial lining)
  • Fibroids
  • Abnormally shaped uterine cavity

Problems within the uterus may interfere with implantation of the embryo or may increase the incidence of miscarriage. The test(s) typically performed to assess the uterine cavity include a hysterosalpingogram (HSG) or sonohysterogram (SHG or SIS). Similar to the HSG, a thin tube-like instrument passes into the cervix. Small amounts of saline are injected into the uterus under ultrasound guidance to assess the uterine cavity. This is the preferred test for uterine abnormalities.

Surgery may be required to further evaluate and possibly correct uterine cavity abnormalities.


Recurrent Pregnancy Loss