Congenital Uterine Anomalies

Müllerian Anomalies

Congenital uterine anomalies (CUA), Müllerian anomalies, are congenital malformations of the uterus, meaning they occur during embryonic development. Most women with uterine abnormalities do not experience symptoms in day-to-day life.

In fact, according to a study published in 2011 by the Oxford University Press, only about 5% of women who participated in the study, without a history of infertility or miscarriage, were diagnosed with uterine anomalies.

However, for women with a history of infertility or miscarriage, the chance of uterine abnormalities can be as high as 20 percent.

Explanation & Effects

During embryonic development, the uterus forms as a result of the Müllerian ducts (located on the sides of the pelvis) fusing into one simplex uterus as the fetus grows longer. Congenital Uterine Anomalies occur when a malformation occurs in the process of fusing the Müllerian ducts.

The cause of uterine anomalies is largely unknown at this time. Women diagnosed with a CUA have not displayed any abnormalities such as an abnormal quantity of chromosomes or chemical levels.

Congenital uterine abnormalities are generally asymptomatic; however, possible effects may include an increase in menstrual pain or bleeding or discomfort during sex.

Types of Uterine Anomalies

Septate Uterus

A septate uterus consists of a normally formed uterine surface containing two endometrial cavities. In septate uteri, the two cavities of the uterus are divided by the septum.  If a pregnancy implants on the surface of the septum, miscarriage is common.

Bicornuate Uterus

The most common uterine anomaly, a bicornuate uterus consists of an abnormally formed, indented uterine surface containing two endometrial cavities. The indentation is at the top of the heart-shaped uterus and restricts the space the embryo has to develop in utero. Usually, there is no problem in getting pregnant or carrying the pregnancy, but the need for c-section is increased due to the fetus frequently lying horizontally in the uterus.

Unicornuate Uterus

A unicornuate uterus occurs when only one half of the uterus has formed in utero. Women with a unicornuate uterus are generally still able to become pregnant but are at an increased risk of premature labor and delivery.

Diagnosis, Prevention, and Surgery

In most cases, uterine anomalies can be diagnosed non-surgically through one of the following methods: ultrasound, MRI, or hysterosalpingogram.

Where reproduction is not affected, uterine anomalies can go untreated. Surgical intervention is generally reserved for cases that prevent menstruation or cause pain or for repeated miscarriages. As with any medical scenario, seeking the consultation of a doctor or fertility specialist is highly advised for any questions or concerns regarding congenital uterine anomalies.

It is also important to note that there is a high correlation between some congenital uterine abnormalities and congenital kidney abnormalities. If diagnosed with a CUA, it is highly suggested to ask your doctor about a kidney screening!

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