Patients with uterine abnormalities are usually considered infertile. With improper development of the uterus and retaining menstrual function, a woman with congenital uterine pathology has a chance to become a mother only in very few cases (10%-20%). But even if the pregnancy has taken place, special caution should be exercised. Fetal survival makes up about 40% in women with uterine disorder. One in three women with uterus abnormalities faces miscarriage. Preterm labour occurs in 20-30% of all patients with primary (inborn) or secondary (acquired) uterine misshapes. In 50% of all cases of the untreated uterus abnormalities a caesaerian surgery is needed to avoid baby traumatizing.
The European Fertility Society highlights the following types of uterine malformations, which are likely to interfere with a fertility function:
- All kinds of uterus malformation (only one Mullerian duct, horn obstruction, uterus with an extra septum etc.)
- hyperplasia of the uterus
- polyps, fibroids and other benign tumors (acquired abnormalities of the uterus)
These diseases are often diagnosed in infertile women, as they prevent the successful implantation of a fertilized egg, and significantly increase the risk of miscarriage. According to statistics, miscarriages are three times as likely to occur in patients with uterine malformation as in women with normal uterus form and function.
To assess the condition of the uterus a number of modern diagnostic techniques are performed at German fertility centers. Hysterosalpingography (HSG) is one of them. In order to identify uterine or ovarian abnormality, special solution is injected into the abdominal cavity through the cervical canal. An obstruction of the fallopian tubes, congenital malformations, hyperplastic changes, adhesions, polyps or fibroids disrupt the solution circulation, which is a direct sign of an abnormality.
To get more diagnosis information, the specialist may need to implement an endoscopic (laparoscopic) technique. The latter involves the introduction of a miniature video camera into the uterine cavity. The study is carried out by means of endometrial ultrasound monitoring, which implies the repeated evaluation of uterus condition during the menstrual cycle. The special advantage of endoscopic techniques is that they not only allow to detect the pathology, but also to conduct minimally invasive surgery.
If uterus abnormality leads to problems with conception, a special surgical correction of the form of the uterus is performed in Germany. After a minimally invasive uterus correction a special intrauterine device is introduced into the organ to prevent the formation of adhesions. Besides, a specialist prescribes cyclic hormone therapy (estrogen drugs) for 3 months, which helps to normalize the hormone balance and to make the uterus ready for further pregnancy. Statistically 70% of women can get pregnant 6-9 months after the surgical correction of uterus form.
For the surgical treatment of bicornuate uterine (uterus with two horns) or other formal deviations a lаparoscopic treatment should be performed. Through 1-2cm "point" incisions special manipulators are introduced into the cavity of the abdomen. The uterus form is usually corrected within a 30-60 minute procedure. In very few cases a two-step surgery is needed. In the first step a surgeon shapes the uterus and in the second step eliminates the disorder of its horns. For rehabilitation after the uterine correction surgery you should plan at least 3 days of stay at the hospital. The two-step surgery will require a week of rehabilitation.
In Germany the removal of endometrial polyps and tumors is performed with special laser devices. The laser techniques help to treat the polyp zone, without injuring the rest of the endometrium, which is very important especially for nulliparous women. Non-injured lining of the uterus and no scars are the major advantages of the laser techniques, since a woman can get pregnant in 2-3 months after the intervention.
Hysteroscopy is a new method, which helps to manage the muscular tumors (uterine fibroids) with submucous type of location without interfering with uterine lining. The precise node removal helps to reduce the risk of recurrences and increase the pregnancy chances by 50%. This minimally-invasive method is also indicated for intrauterine septum dissection as well as dissection of adhesions and endometrial resection. The cost of hysteroscopy in Germany makes up about 10 000-15 000 euro.
Detection and treatment of uterus malformation depends on the type of the disorder. If you feel anxious because of uterine abnormality or suspect one, please don’t hesitate to call our specialists for consultation and medical support. We will help you to find an experienced gynecologist in Germany, who will manage you uterine condition in a most delicate and efficient way.