Conditions Which May Cause Infertility

Endometriosis

Endometriosis is a common condition among women where endometrial glands which normally line the uterine cavity become implanted in the pelvic cavity, outside the uterus. The exact cause of this condition is unknown. However, it is well known that endometriosis is associated both with pelvic pain and infertility. It is not clear how the endometriosis interferes with fertility but in many instances, surgery for this condition can improve fertility. Most often, endometriosis can be treated conservatively by laparoscopy while preserving the uterus, fallopian tubes and ovaries in women who desire future conception. Physicians at the University of Iowa are skilled laparoscopic surgeons and have performed many surgical procedures for women with endometriosis with good results.

Uterine Fibroids

Uterine fibroids are also known as myomas or uterine leiomyomas are very common smooth muscle tumors of the uterus. They are present in 30-40% of women. In many women they are asymptomatic but in some women they can cause disturbingly heavy periods. We also believe that fibroids can interfere with fertility by impairing implantation and perhaps causing miscarriages. Fibroids that are located directly under the endometrium are thought to be the most problematic in terms of fertility. It is unclear whether fibroids that are away from the uterine cavity also known as subserosal or intramural fibroids cause infertility.

The physicians at the University of Iowa are skilled at performing myomectomy both by laparoscopy and laparotomy. We have also performed many hysteroscopic resections of uterine fibroids. These surgeries can add in enhancing fertility in some women.

Pelvic Adhesive Disease

Pelvic adhesions or scar tissue can form from a variety of causes including previous pelvic infection, endometriosis or a previous pelvic surgery. The adhesions may interfere with fertility by blocking the fallopian tubes preventing sperm from ascending through the fallopian tubes to get into a position where they can fertilize the released egg. Physicians at the University of Iowa are skilled at removing and correcting fallopian tube damage caused by scar tissue. This surgery can be performed either by laparoscopy or by laparotomy and all Division members have been fellowship trained in this type of specialized surgery.