The uterus, along with its cervix, is a solid organ with a central cavity that communicates with the vagina. We call this cavity virtual because it does not normally exist; it is necessary to canalize it and insufflate it in some way in order to be able to access it. For example, when we want to perform an endoscopy of the uterus - a hysteroscopy - we need sterile liquid to distend and be able to visualize this cavity in order to study it.
The endometrial cavity has an internal layer which is an endothelium that transforms and grows with the hormonal changes of the ovarian cycle, which leads it to significantly increase its thickness, preparing it to receive a pregnancy, and which flakes off, detaches and is expelled with the menstrual period into the vagina. If this expulsion were not carried out, it would remain inside the uterus and a blood cyst would be produced inside the endometrial cavity, which would no longer be virtual because of the contents that occupy it. In this specific case, it would be sufficient to reestablish normal communication between the uterus and vagina to solve the problem and achieve pregnancy.
If the endothelium of the endometrium is not transformed and the period does not occur, pregnancy would be impossible, even if the cervix is open and artificial insemination can be performed. It is the normal endometrial tissue that facilitates or prevents pregnancy, not the fact that the cervix is more or less stenosed.
Thus, what is important to have clear in the previous study is how menstruation has been occurring and how the endometrium grows and transforms. If these parameters are correct, AI can be performed successfully. The seminal transfer cannula for AI is narrow enough to pass into the endometrial cavity, however difficult the endocervical passage may be.