A small percentage of women face difficulties in conceiving due to a malformation in the uterus. A congenital uterine malformation is a deviation in the shape of the uterus that may occur during a woman's prenatal development. Some uterine malformations are present from birth, while others develop during the woman’s adult life.
Specific uterine malformations include septate uterus, bicornuate uterus, unicornuate uterus, arcuate uterus, didelphic uterus, or T-shaped uterus. The septate uterus seems to be the most frequent anomaly accounting for 30 to 50% of all cases, followed by the bicornuate uterus and unicornuate uterus.
A bicornuate uterus is a condition where the uterus, instead of being pear-shaped, is formed like a heart. This gives the embryo less space to grow than in a normally shaped uterus. Surgery may be performed to create a larger uterine cavity and to correct this condition. However unicornuate uterus and didelphic uterus cannot be surgically corrected.
Diagnosis of a Uterine Malfunction
The physician uses imaging techniques to analyze the character of the malformation in the uterus and they are generally revealed at the time of the first sonographic examination in early pregnancy. When the diagnosis is made at the beginning of pregnancy, preventive treatment such as taking rest, and periodic sonographic monitoring of the fetal growth are recommended.
However, unicornuate uterus is difficult to locate as also discrete forms of septate and bicornuate uterus. 3D ultrasonography seems the ideal method of imaging for uterine malformations. An evaluation of the uterine malformations should be accompanied by a renal investigation as there can be a direct association between the malformation and the kidneys.
Uterine Malfunction and Infertility
Patients with uterine malformations have higher rates of reproductive loss, preterm delivery, breech presentation and complications that increase obstetric intervention. The risk of breech or transverse presentation is higher, since normal rotation of the fetus in the uterine cavity is impeded.
It is seen that pregnancy outcome is poorer in the bicornuate and arcuate uterus groups. The incidence of miscarriages seems to be highest in the case of septate uterus. Early abortions can also be traced to uterine malformations.
However, uterine malformations are not the only factor responsible for infertility; this condition can increase the risk of endometriosis. Uterine problems are but one of the causes of infertility which can be revealed in the course of basic infertility tests.
Treatment of Uterine Malformation
Surgical intervention differs from case to case and depends on the extent of the specific problem. For a septate uterus, surgery is performed to remove the septum (wall). The procedure is performed either through hysteroscopy or laparoscopy. Once this corrective surgery is done, chances of conceiving are good.
At East Bay Fertility Center, California, couples dealing with infertility get access to the latest technology and comprehensive consultation with a reproductive endocrinologist and fertility specialists. East Bay specializes in providing infertility treatments such as in-vitro fertilization, insemination, Intracytoplasmic sperm injection, egg donation and gestational surrogacy. Call 925.828.9235 for a free initial consultation.
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