Uterine Factor Infertility (UFI)

Definition - What does Uterine Factor Infertility (UFI) mean?

Uterine factor infertility (UFI) is defined as an inability to conceive due to an abnormality of the uterus, which hinders implantation of the fertilized egg or embryo and the subsequent events of pregnancy. It is a rare condition affecting 3% to 5% of women worldwide.

FertilitySmarts explains Uterine Factor Infertility (UFI)

A variety of uterine factors can contribute to infertility as follows:

  • Adhesions or scar tissues within the uterus such as that caused by Asherman’s syndrome
  • Uterine fibroids: Noncancerous growths in the uterus but only those that distort the uterine structure will lead to infertility
  • Uterine polyps or outgrowths within the uterus (only those that distort the uterine structure
  • Severe pelvic infections (pelvic inflammatory disease, PID)
  • Surgical removal of the uterus such as due to fibroids, endometriosis, or cancer
  • Congenital uterine factor infertility (present since birth) such as that occurs in:
    • Mayer-Rokitansky syndrome, in which the uterus fails to develop properly
    • Septate uterus: A condition in which the uterus is divided into two halves by a thin wall (called septum) since the girl is born. This prevents implantation of the embryo and its growth within the uterus
    • Bicornuate uterus: A condition in which the uterus has two horns divided by a line or septum

Treatment of UFI varies with the underlying cause. In women with a septate uterus, hysteroscopic metroplasty has shown effective results. This is a procedure in which the septum is surgically divided using a hysteroscope. A hysteroscope is a thin camera that is passed through the vagina and cervix into the uterus. This enables the doctor to directly visualize the inside of the uterus. Hysteroscopic metroplasty can cut the spontaneous abortion rates from 91% to 17% on average.

Similarly, a specialized x-ray termed as a hysterosalpingogram (HSG) is used to assess the fallopian tubes and the uterus. In this test, a small plastic tube is passed through the cervix and a special dye is poured into the tube so that it can flow through the cervical canal into the uterus. This dye allows the physician to examine the inside of the uterus as well as the Fallopian tubes. Doctors prefer hysteroscopy over HSG because the former also facilitates any treatment when required.

Following surgical correction of a septate or bicornuate uterus, doctors recommend that patients wait at least three months prior to conceiving, plus when its time for delivery, they generally favor delivery by cesarean section. This precaution is taken due to an increased risk of uterine rupture during labor for women with a surgically corrected bicornuate uterus.

If the uterus is severely damaged or absent, the only option left to conceive is using a surrogate and in vitro fertilization (IVF).

Recently, a new procedure known as uterus transplantation has been studied as a potential treatment for the uterine factor infertility. The surgical procedure involves transplanting a healthy uterus into the affected woman.

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