Uterine malformations and their impact on fertility

Uterine malformations are structural abnormalities of the uterus that develop during foetal growth. These conditions can affect fertility, increase the risk of pregnancy complications, and, in some cases, cause recurrent miscarriage.

What are the different types of uterine malformations?

• Septate uterus – A fibrous or muscular band divides the uterine cavity, increasing the risk of miscarriage.
• Bicornuate uterus – The uterus is partially divided into two cavities, which can cause pregnancy complications.
• Unicornuate uterus – One side of the uterus fails to develop fully, leading to a smaller uterine cavity.
• Didelphic uterus – Two separate uterine cavities form, often with two cervices.
• Arcuate uterus – A mild indentation in the uterine cavity, generally causing fewer issues than other malformations.

How do uterine malformations affect fertility?

• Implantation difficulties – Abnormal uterine shape can interfere with embryo attachment.
• Higher risk of miscarriage – Septate and bicornuate uteri are associated with pregnancy loss.
• Preterm birth risk – Some abnormalities can lead to early delivery due to reduced space for fetal growth.
• Increased risk of breech position – Babies may not have enough room to turn head-down before birth.

Can uterine malformations be treated?

• Surgical correction – Procedures like hysteroscopic metroplasty can remove a uterine septum.
• Fertility treatments – IVF may help in cases where implantation is affected.
• Monitoring during pregnancy – Regular scans and medical management can reduce risks for women with a uterine malformation.

Uterine malformations can impact fertility and pregnancy outcomes, but many women with these conditions can still conceive and carry a pregnancy successfully. Early diagnosis and appropriate treatment options can improve reproductive outcomes and reduce complications.