Fallopian tube health
The fallopian tubes, the two channels connecting the ovaries to the uterus, are typically the site of fertilization. A blockage of the fallopian tubes—or in the case that one or both are removed—means that the egg can’t meet the sperm (or vice versa) for fertilization.
Factors affecting fallopian tube health:
Illnesses such as PID or endometriosis, medical and/or surgical history
Pelvic inflammatory disease (PID), usually caused by untreated sexually transmitted infections, endometriosis, or past surgeries can result in scarring and blockages within the fallopian tubes. An ectopic pregnancy—when a fertilized egg implants somewhere other than the uterus, such as within a fallopian tube—can also result in scarring or in a fallopian tube that needs to be surgically removed.
Tests for fallopian tube health:
An HSG (hysterosalpingogram)
Finally, once an egg is fertilized, it needs a nourishing uterine environment to implant and grow. In preparation for a fertilized egg, a healthy uterus develops a thick lining (endometrium)—an optimal place for embryo implantation. This lining also assists in the development of the placenta, which supplies oxygen and nutrition to a growing fetus.
Then, during pregnancy, the uterus needs to expand to accommodate the growing fetus and the placenta. Problems with the uterus could result in an embryo that doesn’t implant; in miscarriage, as the embryo/fetus does not develop properly; or even in an increased risk of early delivery or the need for a cesarean section.
Factors affecting uterine health:
Anatomical problems (sometimes congenital), fibroids or polyps, endometriosis
Sometimes, the uterus may be an abnormal shape or structure (such as a septate uterus, which is divided into two sides by uterine tissue), preventing normal embryo development. Large growths within the uterus such as fibroids or polyps—or the tissue growth or scarring associated with endometriosis—may make it impossible for the uterus to expand as it should during a pregnancy.
The good news is that uterine health is not directly affected by age, and the uterus can carry a pregnancy up until menopause—or even after menopause, with proper hormonal support.
Tests for uterine health:
Regular ultrasound or saline infusion sonogram can identify abnormalities of the uterus, growths within the uterus, and the thickness of the uterine lining. Endometrial biopsy can evaluate the uterine lining for abnormal cells and proper hormone levels.
Gestational carrier (surrogate)