When it comes to fertility issues, the sperm health and egg quantity or quality are considered. While these are important, what about the reproductive organs? Abnormalities in the uterus can cause many issues, including infertility. Here is everything you need to know about the various types of uterine abnormalities, including their causes, symptoms, and treatments.
The uterus is a female reproductive organ that houses the fetus during pregnancy. It is hollow, muscular, and pear-shaped. It also regulates menstruation and plays an important role in hormonal balance in the body.
The uterus, like all other organs, is formed in the fetal stage itself. It is essential for the uterus to be in the right shape, size, and location for a female to have regular menstruation and a successful pregnancy.
Abnormalities in the uterus are also known as anomalies. These abnormalities occur due to malformations of the uterine structure during fetal development. When the Müllerian ducts do not grow or fuse properly during fetal development, it results in congenital malformations.
In many cases, the woman may not experience any symptoms at all. Many women with these abnormalities are still able to have healthy pregnancies. In some rare cases, the abnormalities can cause repeated miscarriages or failed pregnancy attempts. The abnormalities are discovered only when a scan is taken to identify the potential cause for the repeated miscarriages.
The different types of uterine abnormalities are -
● Septate Uterus – The uterus is split into two in the middle or to the side by a fibrous or muscular wall. This abnormality significantly increases the risk of repeated miscarriages.
● Bicornuate Uterus – The upper portion of the uterus does not fuse properly, resulting in a heart shape with a deep indentation.
● Unicornuate Uterus – The uterus develops only on one side and almost resembles a banana. This abnormality increases the risk of ectopic pregnancies.
● Uterus Didelphys – Two separate uteruses are present. Most often there are two cervices and a double vagina as well.
● Arcuate Uterus – This abnormality causes a small indentation at the top of the uterus. In most cases, it causes no trouble. However, it may cause late-term miscarriages in rare cases.
● T-Shaped Uterus – The uterine cavity is T-shaped. Earlier, it was associated with fetal exposure to Diethylstilbestrol, a synthetic form of estrogen. Studies now link this abnormality to conditions like uterine adhesions or adenomyosis.
● Absent Uterus (Müllerian Agenesis) – The uterus is significantly underdeveloped or completely absent, thus preventing pregnancy.
In most cases, uterine abnormalities are congenital, meaning the issues are present from birth itself. The exact reason for this is unknown. These uterine abnormalities often go undetected until a woman is older and begins trying to conceive. Hence, it is difficult to narrow down the cause or the exact timing of such malformations during fetal development.
Many women with uterine abnormalities do not experience any symptoms. Most women discover the abnormality only when they undergo a uterine scan for pregnancy or to investigate repeated pregnancy failures. Some common symptoms one may experience are –
● Repeated miscarriages
● Painful menstruation
● Pain during sexual intercourse
● Abnormal vaginal bleeding
● Infertility or repeated pregnancy attempt failure
● Preterm birth
Not all uterine anomalies can be successfully treated. The treatment depends on the type of abnormality and the extent of structural malformation.
● Management – For unicornuate or didelphic uteruses, the pregnancy is closely monitored. The pregnancy is classified as high risk, and regular scans and prenatal visits help ensure the pregnancy progresses smoothly.
● Metroplasty- Also known as a hysteroscopic septum resection, this is the most commonly used method to treat a septate uterus. A thin hysteroscope with a camera attached at the end is used to carefully remove the septum, splitting the uterus. Once removed, the chances of a successful pregnancy increase significantly.
● Surrogacy – When there is no uterus, or it is severely deformed, the only option for pregnancy is through surrogacy. Since the uterus cannot carry a fetus, a surrogate can help when a biological child is a priority.
No, unfortunately, no one has any control over this. These are congenital abnormalities, meaning they develop during fetal development without any clear reason or symptom. Neither the expecting mother nor her doctor can force or prevent this malformation. These abnormalities are only detected during a uterine ultrasound.
Abnormalities in the uterus are not a common occurrence, and not all such anomalies result in infertility or require surgery. With effective management by well-qualified professionals associated with a good facility, successful pregnancies are possible despite uterine abnormalities.
The exact cause of abnormalities in the uterus is unknown. In most cases, it is congenital, meaning it is present from birth due to a malformation in the fetal stage. As this is a rare occurrence, there are no studies or data to help us understand the possible causes of these abnormalities.
In most cases, there are no obvious symptoms. Most women discover their uterine abnormalities only when they undergo a uterine ultrasound during pregnancy or to understand the reasons for failed pregnancies. Some of the symptoms one may experience are irregular bleeding, unexplained vaginal bleeding, repeated miscarriages, pain during menstruation or sexual intercourse, and preterm birth.
Yes, uterine abnormalities can interfere with pregnancy attempts, making it difficult to conceive. Certain abnormalities result in repeated miscarriages, thus affecting fertility or leading to infertility.
Only an ultrasound scan of the uterus can confirm any malformation. Repeated miscarriages, failed pregnancy attempts, or preterm births are common symptoms that push the doctor to identify the reasons behind them. Symptoms like repeated miscarriages, pain during menstruation or sexual intercourse, and irregular bleeding may indicate uterine abnormalities, but only an ultrasound scan can confirm the same.
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