Cervical Stenosis and IVF

What is cervical stenosis?

  • The passageway from the vagina to the main body of the uterus, also know as the cervix becomes narrow or completely closed [1]

  • Cervical stenosis may lead to

    • hematometra - a pathologic collection of blood in uterus

    • pyometra - infection in the uterus

    • subfertility - generally describes any form of reduced fertility with prolong time of unwanted non-conception [2]

  • Cervical stenosis can be congenital or acquired.

    • Most common acquired causes include [3]:

      • Menopause

      • Cervical surgery (eg, conization, cautery)

      • Endometrial ablation procedures to treat uterine abnormalities that cause menorrhagia

      • Cervical or uterine cancer

      • Radiation therapy

    • History of endometriosis, pelvic inflammatory disease, prior surgery and polyps in significantly associated with cervical stenosis [4]

How does cervical stenosis impact fertility?

Often times with cervical stenosis, sperm cannot pass through the cervix to fertilize the egg

How is cervical stenosis diagnosed?

  • Cervical stenosis is often diagnosed when clinicians have difficulty accessing the uterine cavity during other tests (e.g., Pap test)

  • It may be suspected based on symptoms and signs (particularly development of amenorrhea or dysmenorrhea after cervical surgery)

  • Diagnosis of complete stenosis is established if a 1- to 2-mm diameter probe cannot be passed into the uterine cavity [5]

What can be done during IVF to help improve pregnancy rate for women with cervical stenosis?

Cervical Stenosis Overview
Cervical Stenosis and Radiographic features

Last Reviewed: September 21, 2023