What are the causes by which uterine malformations affect infertility?

Whether uterine malformation causes female infertility depends on the severity and type of the malformation. Specific underlying mechanisms are as follows:

Following uterine malformation, the uterus may be unable to properly receive semen and sperm, impairing sperm capacitation and thereby compromising conception. Abnormal uterine shape and volume severely affect blastocyst implantation, endometrial receptivity, and subsequent embryonic development. Furthermore, abnormal myometrial development may occur, preventing normal development of the fertilized ovum and embryo, ultimately leading to early miscarriage.

Additionally, uterine malformation can impede placental attachment and development, resulting in placental malposition, fetal growth restriction, and an increased risk of preterm birth. Moreover, poor endometrial development may lead to ovulatory dysfunction, sex hormone imbalances, reduced sperm viability, and severe impairment of blastocyst implantation, endometrial receptivity, and embryonic development.

Therefore, appropriate diagnostic evaluations are essential. Transvaginal ultrasound is one of the most commonly used gynecological imaging modalities; it employs ultrasound technology to visualize cross-sectional anatomy of the target area and its relationship with surrounding organs. Alternatively, laparoscopy—a minimally invasive surgical procedure—may be performed, utilizing a laparoscope equipped with video and imaging systems to directly examine the uterus and fallopian tubes.