Can't have a baby because of a problem with the uterus? Let's talk about (Uterine Factor Infertility)

When trying to make the dream of having a child come true, sometimes we have to face unexpected problems. Maybe your doctor told you that the problem is in the uterus? It is very normal to feel very sad and shocked when you hear something like this. But don't worry. Let's understand this properly, because awareness is the first step on this journey.

What is Uterine Factor Infertility?

Simply put, this is when a person is unable to get pregnant. The reason for this is that their uterus is either not present from birth or, even if it is present, it is not functioning properly. We all know that a child is born and grows in the mother's womb, that is, in the uterus. So if there is any problem in this uterus, it directly affects pregnancy.

There are main types of this condition.

This condition can be divided into two main categories: depending on how it occurs.

What are the reasons for this? Let's take a deeper look.

Let's talk in a little more detail about why this happens.

Being born without a uterus

This is a very rare congenital condition. Medically, it is called `(Mayer-Rokitansky-Küster-Hauser syndrome - MRKH)`. A person with this condition has a congenitally underdeveloped vagina and uterus, or they are very small. But surprisingly, the ovaries are often healthy . Because the ovaries are functional, they secrete hormones normally, so things like mood swings related to the menstrual cycle can occur. However, because there is no uterus, there is no menstrual bleeding. This condition is usually diagnosed at a young age, that is, when menstruation has not started by the age of 15-16.

Hysterectomy

A major reason for this is that at some point in life, the uterus will need to be surgically removed. There can be several reasons for such a surgery.

• Severe bleeding (hemorrhage): Sometimes, if there is severe bleeding that cannot be stopped during a C-section or other surgery, the uterus may need to be removed as a last resort to save life. This is very rare.
• Uterine cancer: The uterus is removed to stop cancer cells from spreading to other parts of the body.
• Other serious conditions: When severe abdominal pain and heavy bleeding caused by conditions such as endometriosis, uterine fibroids, or adenomyosis cannot be controlled with other treatments, doctors recommend removing the uterus as a relief.
• Scarring of the uterus: Certain infections, radiation therapy, or surgery to clean the uterus (Dilation and Curettage - D&C) can cause scar tissue to form inside the uterus and cause adhesions. This condition is called Asherman's syndrome. This scarring makes it difficult for a fetus to implant in the uterine wall.

How to recognize this condition?

Your doctor will follow several steps to diagnose this condition.

• Medical history: First, you will be asked about your menstrual cycle, previous surgeries, and other medical conditions.
• Physical examination: The abdominal area is examined.
• Scans: An ultrasound scan can clearly see the shape, size, and even whether the uterus is present. Sometimes an MRI scan may be done for further confirmation.

What are the treatments and options for this?

For a long time, the only options for someone without a uterus to have a child were adoption or gestational surrogacy.

But recently, with the advancement of medical science, a new hope has emerged: uterus transplantation .

This is still not a common practice in many countries around the world, but there have been several cases where it has been successful.

How does a uterus transplant happen?

This is also a complex surgery, like transplanting an organ like a liver or kidney.

• Uterus transplantation: A healthy uterus is transplanted from a living person (e.g., a close relative such as a mother or sister) or from a deceased person (brain-dead donor).
• Embryo preparation: Before the uterus is transferred, embryos are created using IVF technology using the recipient woman's eggs and her partner's sperm, and they are frozen.
• Implantation: After surgery, once the body has adjusted to the new uterus, the previously prepared embryos are transferred into the uterus one by one.
• A temporary transplant: This is not a lifelong procedure like other organ transplants. Usually, after one or two children have been born, the transplanted uterus is surgically removed.
• Why is it removed again?: To prevent the body from rejecting a newly transplanted organ, you need to take lifelong medications (immunosuppressants). These medications have side effects. So, after the goal of having children is achieved, the transplanted uterus is removed in this way to reduce the risk of continuing to take these medications.

Can this situation be prevented?

There is no way to prevent this congenital condition, as it occurs while a baby is still in the womb. It cannot be detected in advance through scans during pregnancy.

But we can be somewhat careful about acquired conditions during life. For example, before undergoing hysterectomy for a condition such as uterine fibroids, it is important to talk openly with your doctor about your future dreams. Then, we can discuss whether there are alternative treatments that do not require removal of the uterus.

But remember, sometimes a hysterectomy is a life-saving emergency surgery. In such a situation, there may be no time to think about alternatives.

Uterus, Infertility, Child Loss, Uterine Factor Infertility, Hysterectomy, Uterine Implant, Women's Health