Uterine abnormalities are thought to affect up to one in 20 women who seek treatment for infertility. In most cases, uterine abnormalities don’t prevent a woman from getting pregnant.
By Dr. Gunjan Gupta GovilCongenital malformations (birth deformities) of the uterus can occasionally be attributed for infertility. They can result in repeated miscarriages and make it difficult to bring a pregnancy to term, in addition to causing infertility. With an abnormal uterus, a woman seeking to get pregnant has very little chance of carrying a pregnancy to term. In fact, an abnormal uterus contributes to around 10% of all cases of female infertility. Occasionally, uterine abnormalities can develop while the foetus is still in the womb. A woman’s reproductive organs develop while she is still a foetus within her mother’s uterus, much like other organs in the body. “Mullerian abnormalities” refer to any flaw in the uterus and fallopian tube’s development. Mullerian abnormalities can take many different forms, ranging from no uterus to a full duplication of the uterus, cervix, and vagina (didelphys), etc
What is an abnormal uterus?
A smaller percentage of women have uterus that are abnormal in shape and structure rather than place. This is referred to as a uterine anomaly or uterine abnormality.
Uterine abnormalities are thought to affect up to one in 20 women who seek treatment for infertility. In most cases, uterine abnormalities don’t prevent a woman from getting pregnant. In fact, many women don’t even recognise they have a problem until they have recurring losses or preterm labour. A uterine abnormality may be detected in cases of frequent, unexplained miscarriages. Accurate diagnosis and frequently rectifiable uterine abnormalities enable a woman to experience a safe pregnancy. The following categories can be used to categorise uterine abnormalities:
Agenesis
This is an uncommon disorder in which there is either no uterus, no vagina, or both. When a girl doesn’t begin her periods by the age of 12 or 13 years old, this is typically suspected. Vaginal agenesis can have an impact on a woman’s sexual life later in life. Surgery can be used to treat the illness, however counselling is necessary for women who have both vaginal and uterine agenesis since they are unable to give birth. A lady with agenesis can only become a mother through surrogacy.
Uterus didelphys
The uterus contains two internal cavities when this syndrome exists. There are two cavities, each of which may lead to a separate cervix and vagina. If one has this kind of anomaly, they may still be able to get pregnant.
Unicornuate uterus
One fallopian tube and half of the typical uterus make up a unicornuate uterus. It is characterised as looking like a uterus with one horn because of its form. It is an uncommon abnormality. A unicornuate uterus suggests that you have two ovaries. But just one will be attached to your uterus. It is entirely feasible to become pregnant as long as there is one, healthy, formed horn. It does, however, increase the chance of miscarriage and premature birth.
Bicornuate uterus
A uterus with two horns and two distinct uterine compartments is what it actually is. It shouldn’t influence fertility because of its form, but there is a larger chance of miscarriage and premature birth.
Septate uterus
Complete septum is less frequent than partial septum. If a woman conceives, having a septate uterus, may increase her risk of miscarriage and infertility.
Common Symptoms
Many times, an atypical uterus doesn’t create any issues and may even go unnoticed until menstruation or until an attempt at conception. Menstrual outflow will be impeded if a uterine abnormality, like a unicornuate uterus, is connected to a primitive uterine horn with no outlet. Pain that worsens during periods might arise from this. Blood builds up in the uterus and might get infected if left untreated – Infertility, ectopic pregnancy, recurrent miscarriage, early birth, dysmenorrhea, irregular bleeding, etc. may also be linked to uterine abnormalities.
Procedures used to diagnose abnormalities in uterus may include:
- Pelvic exam
- Hysterosalpingogram
- Ultrasound
- MRI
- Laparoscopy
- Hysteroscopy
Treatments for Infertility
Not all uterine abnormalities can lead to infertility. In reality, many uterine defects can be medically fixed if necessary. In the event of vaginal agenesis, neovagina can be created. The uterus is most frequently reshaped with metroplasty. In septate uterus, septal excision can be performed hysteroscopically. Cervical cerclage may be used in specific circumstances to stop the cervix from opening too soon and to improve the chance that the foetus will survive.
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