Can fluid in the uterus cause infertility?

There are different causes which can provoke the fluid and uterus. One of this problem may be hydrosalpinx (liquid in tubes) and sometimes this liquid can come inside of uterus and normally, this is very bad for the implantation and if we can see this kind of condition, we normally say to women to first cut these tubes with liquid because they do not work as organ and they decrease the probability of normal pregnancy by 2 – 3 times around. So, this is one problem with liquid, another problem with liquid is when we see it without some specific treatment, it may be a sign of chronic endometritis. Chronic endometritis, of course, decrease dramatically the probability of normal implantation. It is chronic inflammation. I don’t see very often such endometritis with liquid inside, it is quite rare, it should be quite acute inflammation but it may be. Often we can see liquid when we are doing stimulation, for example, the level of estrogen is very high – in this case, there is kind of liquid mucus inside of the uterus and in this case mostly now we will have implantation.

Fluid inside the uterus can be an incidental finding sometimes that we find during regular ultrasound scans in ladies having fertility treatments. Fluid inside the uterus might impede or might prevent embryos from implanting because embryos are those microscopic organisms that they want a very clear and beautiful lining for them to implant. Where does the fluid come from? Sometimes I have to say it won’t be very challenging and we don’t find a reason. Most of the time we do find a reason though. The fluid can be coming from a problem inside the tube where the tubes have fluid inside them, like hydrosalpinges and that fluid keeps on seeping back inside the uterus and that’s why we are seeing fluid all the time inside the lining. Other causes might be an infection inside the lining causing that lining to produce that fluid, preventing the lining from absorbing the fluid back again. A third cause might be, sometimes we see mainly in ladies who have done a caesarean section, I repeat not in every lady – it’s rarely seen that after the cesarean section sometimes fluid might be accumulating in the caesarean section scar and that fluid might end up seeping back inside the uterus and this is what we see inside the lining. Sometimes we don’t know the reason why unfortunately. There are different ways that we can try medically to try to remove or get rid of this fluid. Sometimes giving progesterone might help the lining to absorb the fluid. The problem depends on the cause, sometimes, if there’s fluid in the tube, then we have to either take the tubes out or clip the tubes, sometimes if there’s a cesarean scar defect, we advise ladies very rarely to have a repair for the caesarean section scar, sometimes we do a hysteroscopy and simply by dilating the cervix we are allowing the fluid to seep out improving the outcome. So there are different ways depending on the reason why the fluid is accumulating. Based on the reason the treatment will be tailored, most of the time we achieve a good success. Very rarely we might fail to know the reason and you might fail to allow the fluid to to to resolve, those will be very challenging medical cases that we need to deal with every now and then but most of the time we are able to help.

If the fluid in the uterus is because of a hydrosalping which is a swollen diseased tube and it is the backtracking of the fluid into the uterine cavity then, there is evidence to say that that affects the implantation and chance of conception. So, an operation to remove the swollen diseased tube should improve the chances.

It could do. It’s really unusual to find fluid in the uterus apart from just after or while you’re still having a period. In some people, you’ve had a previous cesarean scar, there’s a little focus, a little area there where the scar hasn’t quite repaired properly, which is pretty common because not all scars completely heal as normal. You can sometimes get a collection of fluid there, that leads back down to the lining of the womb, that we sometimes see. The vast majority of the time, that fluid comes and goes and it’s not a problem but if it lingers when an embryo is trying to implant, it may potentially have an impact and sometimes you have to aspirate that fluid to make sure the lining is okay. Very very rarely, if somebody’s got a significant scar defect, that can again be surgically repaired but again it’s a balance of making sure you don’t cause more problems.