diagnosis guide
If you’ve just received a medical diagnosis, or you’re concerned that something in your present or past health history might be jeopardizing your fertility, check here for quick info on common medical conditions and how they can affect conception and pregnancy.
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Scarring
What It Is
Scarring refers to tissue or adhesions produced as a result of healing after surgery or trauma, or by the body’s reaction to certain disease.
Who Gets It
Major causes of scarring in a woman’s reproductive organs include pelvic inflammatory disease (PID, usually caused by untreated STDs), and chronic endometriosis, a disease in which the tissue lining the uterus migrates to the ovaries and fallopian tubes where it builds up and triggers formation of scar tissue. Scarring inside the uterus also can result from surgery such as dilation and curettage (D & C) and removal of fibroids. Any type of surgery in the pelvis or abdomen – even an appendectomy – can cause scarring around the reproductive organs.
Symptoms
Often the first symptom of tubes blocked by scarring is difficulty conceiving. Many women with uterine scarring have light periods, or no periods at all. Some feel period pain without the actual period, which may indicate that menstrual blood is trapped in the uterus. Recurrent miscarriage also may occur.
How It's Diagnosed/Detected
Scarring and blockages in the tubes and uterus can be detected by several procedures: laparoscopy, in which a small lighted wire is inserted through an incision near the navel; hysteroscopy, where a small, thin telescope is inserted through the cervix; and hysterosalpingogram, in which dye is sent through the uterus and fallopian tubes and the organs are then x-rayed.
How It Affects Fertility (And Pregnancy)
Scarring can limit the interaction between the tubes and ovaries and/or block the fallopian tubes, making it difficult or impossible to get pregnant. Women with tubal damage who do conceive are at increased risk of ectopic pregnancy. Scarring inside the uterus causes infertility by limiting the healthy surface area in the uterine lining where an embryo can implant.
Treatment
Laparoscopy and hysteroscopy, the same procedures used to detect scarring, can sometimes be used to remove scar tissue and blockages in milder cases.
Pregnancy Prognosis
In many cases, conception and pregnancy can occur normally after treatment to remove scar tissue and blockages. But if scarring is severe, in vitro fertilization may be necessary to achieve pregnancy.
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