1. Fibroids

2. Uterine Polyps

These are very common small growths dangling in the cavity of the womb and interfere with conception by acting like an IUCD or loop.

3. Adhesions in the uterine cavity (cavity of the womb)

 It may be a consequence of infection or surgery such as D&C (scraping of the uterus).

4. Congenital Problems (problems from birth) like a slightly smaller than normal size uterus or a T shaped uterus and a uterine septum , as in other above problems can be treated with operative hysteroscopy.

However, other congenital problems like an absent uterus, abnormally small uterus (hypoplastic uterus), an abnormal shaped uterus such as double uterus, bicornuate (two-horned uterus) cannot be treated surgically.

Cervical mucus hostility is the inability of sperm to penetrate the cervical mucus.

The cervical mucus is a jelly-like substance produced by minute glands in the cervical canal. It changes in consistency and composition with the menstrual cycle. Just before ovulation and under the effect of the hormone estrogen it becomes very watery and copious to allow the sperm to swim through it. After ovulation and under the effect of progesterone, the mucus becomes thick and sticky, which renders it impenetrable to the sperm. Once the sperm are in the mucus, they can stay there for a few days. Thus the mucus acts as a sperm reservoir.

Problems with cervical mucus usually cause no symptoms and are detected by a Post Coital Test . Problems could arise because there is not enough mucus to allow sperm to swim through, the mucus contains antisperm antibodies or the sperm is abnormal or defective .

This problem can be treated effectively with intra uterine insemination .

Antibodies are substances that circulate in the blood and body tissues. They normally protect the body from invasion by foreign bodies such as bacteria and viruses, in order to prevent the body from getting an infection. For unknown reasons the body may develop antibodies against sperm. The sperm will then be “sensed” as foreign and are attacked by the body in a similar fashion to the way that the body attacks infecting organisms.