diagnosis guide
If you’ve just received a medical diagnosis, or you’re concerned that something in your present or past health history might be jeopardizing your fertility, check here for quick info on common medical conditions and how they can affect conception and pregnancy.
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Uterine Abnormalities
What They Are
Some women are born with malformed uteruses that make it difficult to carry a pregnancy to term. For example, the uterus may be divided down the middle by tissue, developed only on one side, or separated into two horn-shaped structures. In some cases, there may be a double uterus with two cervixes. In extremely rare cases, a woman may have no uterus at all.
Who Gets Them
Uterine abnormalities are rare, affecting only about three to four percent of women. All occur as mistakes during fetal development, but they do not appear to be hereditary.
Symptoms
Sometimes there are symptoms that can indicate a uterine problem. If a woman doesn’t menstruate, or has chronic pelvic or back pain, for instance, it may be due to an obstruction in the uterus that causes menstrual blood to build up in the pelvis. Women with a uterine abnormality also are more likely to develop endometriosis. But often the first indication of an abnormality is the inability to carry a baby to term.
How It's Diagnosed/Detected
Ultrasound is most commonly used to diagnose a uterine problem, because it can evaluate both the cavity of the uterus and its outer contour. Another option is a sonohysterogram, a type of ultrasound that uses saline, sent through a catheter, to examine the uterine cavity. As a last resort, the doctor may order an MRI, which provides a more detailed look inside.
How They Affects Fertility (And Pregnancy)
Generally women with a uterine abnormality won’t have problems conceiving, but will often have difficulty carrying a pregnancy to term. When the uterus is misshapen or divided by a wall of tissue, there isn’t room for a baby to grow to full term, and miscarriage results. Approximately one-third of women with a uterine defect suffer miscarriages, compared to 15 percent of all pregnancies. About a quarter of women with a uterine abnormality have preterm deliveries, in which the baby is born before 37 weeks’ gestation, compared to 10 to 12 percent of other women.
Treatment
In some cases, surgery can remove tissue that divides or fuses parts of the uterus. When the uterus is one-sided or otherwise malformed, doctors may perform a surgical procedure to sew the cervix shut and hold off a too-early delivery. There is no treatment for the rare woman born without a uterus, but it may be possible for a surrogate to carry an embryo created with eggs harvested from the woman’s ovaries.
Pregnancy Prognosis
Most uterine abnormalities don’t affect a woman’s chances of conceiving. And thanks to treatments that are available, more than half of women with an abnormality are able to bring home healthy babies.
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