Infantility (hypoplasia) of the uterus

Anomalies of the uterus and vagina are observed in 4.3-6.7% of all women of childbearing age. They cause infertility in every eighth case, and in 12.6-18.2% they cause recurrent miscarriage, placental abruption, abnormal fetal position and other complications.

One of the most common anomalies of the uterus is its infantility (it is also called hypoplasia) - a defect associated with the small size of the main genital organ. With a slight decrease in the size of the uterus, the anomaly does not manifest itself with any symptoms, a significant degree of hypoplasia can be suspected even in adolescence - by the late appearance and extreme soreness of menstruation.

Causes of uterine infantilism

The girl's uterus begins to form even in the prenatal period - at the 5th week of her development. By the time of birth, she is fully formed, but still very small. Until the age of 9-10, it grows slowly, the first 3 years being in the abdominal cavity, and then descending into the small pelvis. From 10 to 13-14 years old, its growth is greatly accelerated, and by the period of puberty it should reach its normal size: 48 ± 1 mm in length, neck length 26 ± 1 mm (that is, with a total length of 72-76 mm), 33 mm in thickness, 41 mm in width. If this does not happen, then one of the situations took place:

1. The uterus either initially could not develop: either intoxication, which affected the mother's body even in the prenatal period, interfered with it, or there was a violation at the level of genes or chromosomes, due to which the organ would no longer be able to grow;
2. The uterus began to develop, but the girl's body (mainly on her endocrine system) was adversely affected. This could have happened as a result of:

• suffered severe flu: the virus "loves" to affect the main endocrine organs - the hypothalamus and pituitary gland;
• frequent respiratory tract infections: ARVI, chronic tonsillitis;
• nicotine or narcotic intoxication;
• constant stress (they also affect the hypothalamus), including those caused by significant mental and physical stress at school;
• hypovitaminosis;
• tumors of the pituitary gland or hypothalamus;
• ovarian lesions with mumps, measles, rubella viruses;
• insufficient nutrition of the girl, including - and as a result of her adherence to a diet for weight loss;
• operation on the girl's ovaries.

The degrees of the infantile uterus

Depending on the size of the uterus, determined by ultrasound, there are 3 degrees of its hypoplasia:

1. The embryonic uterus: its length is 30 mm or less, there is almost no cavity in the uterus, the length mainly falls on its cervix;
2. Children's uterus: the total length of the uterus and its cervix is 30-55 mm, while the cervix is 3 times longer than the cavity;
3. The adolescent uterus has a total length of 55-70 mm, the ratio of the lengths of the neck and cavity corresponds to the physiological norm.

Signs of an infantile uterus

If the adolescent uterus does not manifest itself in any way, and a woman can find out about such an anomaly only during pregnancy or even after childbirth, then more severe degrees of hypoplasia have their own symptoms:

• late onset of menstruation (after 16 years);
• painful periods;
• irregular periods;
• decreased libido;
• difficulty reaching orgasm;
• infertility or recurrent miscarriage.

Uterine hypoplasia is often combined with other gynecological pathologies: mainly with endometriosis, frequent inflammation of the vagina and cervix. They can mask the manifestations of uterine hypoplasia.

Often, girls with infantile uterus have a characteristic appearance: they are small in stature, thin, with very small breasts and a narrow pelvis. On examination, the gynecologist sees a small amount of pubic hair, underdeveloped labia and a small vagina.

Infantile uterus and pregnancy

With the embryonic type of the uterus, pregnancy can occur only with the use of assisted reproductive technologies, but often it is necessary to resort to surrogacy with a woman's egg.

The child type of hypoplasia makes pregnancy possible, but carrying is associated with the risks of premature birth, placental abruption, abnormal position of the fetus in the uterus, and premature rupture of amniotic fluid.

In the adolescent type of anomaly, in combination with the preserved work of the ovaries, problems with conception and gestation usually do not arise. In the early postpartum period, it is necessary to control the contraction of the uterus.

Diagnostics and treatment in our clinic

Having established a preliminary diagnosis of uterine hypoplasia and determining its degree by ultrasound, the clinic's specialists perform hysterosalpingography: this way they recognize the internal structure of the uterine cavity, determine the tortuosity of the fallopian tubes. After that, we need to draw up the woman's hormonal profile.

Only on the basis of these studies can we draw up a treatment plan for uterine hypoplasia. The main methods that we use for this developmental anomaly are:

• physiotherapeutic methods: magnetotherapy, application of paraffin, ozokerite, endonasal galvanization, mud therapy and other methods;
• vitamin therapy;
• gynecological massage;
• Exercise therapy.

If the degree of uterine infantilism is high, and you want to get pregnant, we will select exactly that assisted reproductive technology that will solve your problem. This can be IVF or fertilization of your egg by ICSI, PIXI, IMSI, followed by the introduction of a surrogate mother's embryo.

Preventive measures and forecasts

When diagnosing a fertile type of infantility of the uterus, the possibility of conception is excluded. In this case, the onset of pregnancy is possible only with the use of assisted reproductive technologies (ART). If the generative function of the gonads is preserved, they resort to in vitro fertilization (IVF) using oocytes ready for insemination.

The course of pregnancy in patients with severe endometrial hypoplasia is associated with a high probability of spontaneous abortion and complicated delivery.

In women with miscarriage syndrome, intracytoplasmic sperm injection (ICSI) is performed as part of surrogacy. With minor changes in the structure of the genital organ and normal secretion of steroid hormones by the ovaries, the chances of conception and successful bearing of the fetus increase by 45-50%.

Conclusion

The full development of a woman's reproductive system is possible only in the event of the elimination of unfavorable endogenous and exogenous factors during puberty. Prevention of pathology consists in the timely treatment of infectious diseases (tonsillitis, pharyngitis, herpes, meningitis), prevention of stressful situations and good nutrition. Preventive measures help prevent the development of hypovitaminosis and endocrine disorders, which increase the likelihood of genital infantilism.