Congenital Uterine Malformations and Fertility

Congenital uterine malformations are birth defects which often present no symptoms. However, they can contribute to miscarriage or premature delivery. While uterine abnormalities only affect about six percent of the population, they occur in 24 percent of women who struggle with fertility. Our doctors at the Fertility Center of San Antonio in San Antonio, TX, may be able to correct some types of congenital uterine malformations through conservative surgical treatment.

illustration of the female reproductive system

Uterine anomalies form prior to birth and can impact your fertility.

What Are Congenital Uterine Malformations?

Congenital uterine anomalies are malformations of the uterus that develop before birth. A woman’s uterus develops as two separate halves that fuse together. When a woman's uterus develops differently, it is called a uterine anomaly or malformation.

Many women with uterine anomalies do not have any symptoms.

Congenital uterine anomalies are rare, affecting less than seven percent of all women. However, these malformations afflict about 24 percent of women who have miscarried or delivered premature babies.

Types of Uterine Anomalies

There are five basic types of uterine malformations, categorized as follows:

  • Arcuate: when the uterine surface has a slight indentation

  • Septate: when the uterus is divided by a band of muscle or tissue

  • Bicornuate: when the uterus is shaped like a heart with two horns

  • Unicornuate: when one half of the uterus is fully developed, and the other half remains underdeveloped

  • Didelphys: when the two sides of the uterus are separated and each has a cervix

The most common uterine anomalies are septate uterus and bicornuate uterus, both of which can affect fertility. Most doctors consider an arcuate uterus a variation of normal uterine development, and it is the type least associated with reproductive issues.

Potential Signs

Many women with uterine anomalies do not have any symptoms. They may only discover the malformation during a pelvic exam or ultrasound. However, common symptoms associated with a uterine anomaly include:

  • Monthly cramping or pain without menstruation

  • Pain with intercourse

  • Inability to empty the bladder

  • Underdeveloped breasts

  • Repeat miscarriages or preterm births

Diagnosing Uterine Issues

Your doctor can typically identify a congenital uterine malformation during a physical examination and medical history review. Other diagnostic procedures we may use include:

  • Hysterosalpingogram (HSG) — This is an X-ray procedure used to assess uterine anatomy and the fallopian tubes.

  • 3-D Ultrasound — The three-dimensional images can help your doctor analyze your uterine shape.

  • Magnetic resonance imaging (MRI) — Large magnet radio frequencies reflect images of the pelvic structure.

Treatment for Uterine Anomalies

In many cases, women with congenital anomalies do not require any treatment. However, if the malformation of your uterus is causing severe menstrual pain or interfering with your fertility, our team may recommend surgery.

The two main surgical techniques used are:

  • Laparoscopy — This minimally-invasive operation is performed using very small incisions in the abdomen, through which a small camera and surgical instruments are inserted.

  • Hysteroscopy — This approach relies on endoscopy techniques with access through the cervix to perform the procedure

Learn More about Your Options

If you are concerned about a uterine malformation affecting your fertility, make an appointment to receive your diagnosis or treatment plan today. You can leave a message for our team online, or speak with us at (210) 692-0577.



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