The hostile uterus is one of the most common fertility issues women face. It refers to the state where the environment inside the uterus is inhospitable. It is a term used to describe either insufficient or poor-quality cervical mucus that is unfriendly to the movement of sperm.

Here’s how it can lead to infertility

The sperm must travel a long and difficult path before reaching its destination to fertilize an egg and form an embryo. Millions of sperm enter a woman’s body following sexual intercourse, but only the healthier and stronger ones reach the vicinity of the egg residing in the fallopian tube after ovulation. The weaker and abnormal sperms are filtered out during their transit through the vagina, cervix, uterus, and fallopian tubes due to the presence of many factors. This allows survival of the fittest.

Any change in the female genital tract, even at a microscopic level, hinders healthier sperm from reaching the egg. It usually occurs in conjunction with abnormal cervical mucus, which creates an adverse environment for sperm and reduces the chances of pregnancy. Today, thousands of couples suffer from this problem, and many of them are not aware of their condition until it’s too late.

The embryo, which is formed after fertilization, migrates from the tube towards the endometrium which lines the uterus. Here, it gets implanted and grows to form a baby. At times, the endometrium may also become detrimental to the growth of the embryo as a result of diverse etiologies.

What is cervical mucus?

The cervix is the lowermost part of the womb, which connects the uterus to the vagina. It produces fluid-like secretions known as cervical mucus, which changes its characteristics with each day of the menstrual cycle due to natural hormonal variations. During the time of ovulation, cervical mucus becomes abundant, clear, watery, and stretchy. This not only allows the healthy sperms to pass through from the vagina to the uterus but also gives them a boost for their journey ahead towards the egg.

As many married couples are unaware of biological rhythms, they are unable to determine the best time to conceive a child. Some engage in sexual activity at inopportune times, such as when there is insufficient mucus, making conception impossible.

What makes the cervical mucus hostile?

Factors such as constant stress, poor nutrition, coffee, nicotine, and genital tract infections can induce abnormal changes in the cervical mucus. In addition, hormonal imbalances also lead to the formation of hostile mucus. The presence of antibodies against sperm in the cervical mucus also makes it inhospitable for the sperm.

Another reason for an inhospitable uterus is the use of lubricants during sexual encounters. They can change the pH of the vagina by interacting with natural uterine secretions. As a result, even the healthiest sperm cannot reach and fertilize the egg. Any previous surgery on the cervix could also lead to inadequate production of cervical mucus, arresting sperm movement.

What happens if there is hostile mucus?

Hostile cervical mucus impairs fertility by:

* Preventing sperm penetration
* Resulting in sperm destruction
* Generate antibodies to semen

How do you diagnose a hostile uterus?

If a couple is unable to conceive for an extended period of time, they should consult an expert, get a thorough health check-up, and undergo necessary tests.

The hostile uterus can be detected only through a detailed medical history and examination and some necessary laboratory tests.

Furthermore, the couple may be advised to undergo post-coital testing to determine whether the sperm remains viable after sexual contact and contact with mucus. Examining the behavior of sperm in cervical mucus can help to determine the quantity and quality (stretching and colour) of the mucus. A negative outcome of such a study could explain why there is no fertilization.

What is the available treatment for a hostile uterus?

Intrauterine insemination (IUI) and in vitro fertilization (IVF) are two of the most effective treatment options.

Intrauterine insemination (IUI): During the procedure of IUI, sperm are directly injected into the uterus, bypassing the abnormal cervical mucus barrier. As a result, the adverse effect of mucus is negated, and the spermatozoa meet the egg at their final destination.

In vitro fertilization (IVF): IVF is used when repeated attempts at IUI fail or there are multiple causes contributing to the couple’s infertility that could only be corrected by IVF. The process entails the doctor aspirating mature eggs from your ovaries, where they are combined with sperm in the laboratory and transferred into the uterus when one or more embryos are ready.