Female infertility due to abnormalities in the uterus

This is an automatically translated article.

The article was professionally consulted by Specialist Doctor I Le Thi Phuong - Obstetrician and Gynecologist - Department of Obstetrics and Gynecology - Vinmec Ha Long International Hospital
Any abnormal growth in a woman's uterus causes not only physiological effects but also causes infertility. There are different types of uterine malformations.

1. What is the uterus?

The uterus (or womb) is an organ located in the female pelvis and is shaped like a pear. The uterus is usually 7.5cm long, 5cm wide and 2.5cm deep. The uterus is composed of the fundus of the uterus, the body of the uterus, and the cervix.
According to statistics, 1 in 18 women will experience an abnormality in the uterus. That woman's uterus will be a different size, structure, or shape than usual.

2. Common uterine malformations

2.1 No uterus

This is an extremely rare form of uterine abnormality with a probability of occurring in 1 in 4,000 – 10,000 women. Most women with this condition have a very small uterus or no uterus, a very short or no vagina, and no menstrual periods, but still have normal fallopian tubes and ovaries.
Although the vagina is short or no vagina, although it can be corrected by performing vaginoplasty, it still makes it difficult for a woman to have sex, leading to difficulty having children.
In particular, a woman will be completely unable to get pregnant without a uterus. Up to the present time, advanced medicine has not been able to perform the technique of artificial uterus transplantation. If the mother wants to have a child, she must ask a surrogate mother.

2.2 Double uterus

A double uterus is also a rare abnormality of the uterus. In this condition, the uterus will have 2 separate uterine chambers, in which each chamber can have a separate vagina and uterus. This means that the person will have two separate vaginas and two uteruses.
Cases of pregnant women with a double uterus are often prone to miscarriage, stillbirth, premature birth or growth retardation due to fragmentation of the arterial branches feeding the fetus, poor elasticity of the uterus and narrow uterine lumen. .
The second uterus does not contain pregnancy lying low, which can obstruct the way out through the vagina of the baby, so pregnant women with a double uterus are prescribed by doctors to give birth by cesarean section instead of vaginal birth to avoid endangering the baby. .

2.3 Domed uterus

This is a condition in which the uterus has a slight abnormality, specifically the bottom of the uterus is slightly recessed. This condition can be detected easily through MRI or ultrasound imaging. The uterus usually has a flat or slightly convex bottom, so when the uterus has a dome-shaped concave, the muscle at the bottom of the uterus overflows into the uterine cavity and forms a small cushion. Domed uterus is a common type of uterine malformation and does not greatly affect fertility. However, there is still some suggestion that a dome-shaped uterus can lead to an increased risk of premature birth or miscarriage.

2.4 Unicorn uterus

Unicornuate uterus (also known as unicornuate uterus) is a condition in which the uterus is only 1/2 the size of a normal uterus and has only one fallopian tube.
Women with a single uterus often have difficulty conceiving naturally and often assisted reproduction by in vitro fertilization or sperm injection.

2.5 Two-horned uterus

A bicornuate uterus is an abnormality in the structure and shape of the uterus. Instead of being shaped like an upside down pear, the bicornuate uterus is more like a heart. That's why this condition is also known as a heart-shaped uterus.
Pregnant women with bicornuate uterus are prone to miscarriage, premature birth or poor fetal growth due to volume limitation of the uterine cavity.

2.6 Uterus with septum

Another abnormality of the uterus that affects a woman's pregnancy is when a short wall divides the uterine cavity. This septum can extend from the fundus to part of the uterus or even all the way to the cervix.
Whether it is a partial or complete septum, it affects a woman's ability to get pregnant. The narrow lumen of the uterus leads to an increased risk of miscarriage or premature birth. Often for cases of uterus with septum will be indicated to perform hysterectomy before pregnancy.

3. Abnormalities in the uterus how affect pregnancy?

Not all cases of uterine malformation lead to infertility. Depending on the extent to which the uterus of the pregnant woman is malformed, combined with many other factors will determine the possibility of pregnancy. If there are some abnormalities in the uterus that are not too serious, then the woman can still have a normal pregnancy.
However, pregnant women need to be careful because any abnormality in the uterus has a high risk of miscarriage, poor growth or premature birth. Therefore, the mother needs to have a reasonable rest regime and go to medical facilities as soon as there is a suspicion of uterine malformation to be diagnosed and have timely remedies. This is extremely important to help you and your baby have a healthy pregnancy.
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