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What Is a Bicornuate Uterus and How Does It Affect Fertility?

Overview

If you have a bicornuate uterus, it means that your uterus in heart-shaped. The uterus is the organ in a woman’s body that holds a baby. This condition is sometimes referred to as a “heart-shaped” womb because it actually looks like a heart.

The shape of your uterus is important if you become pregnant because it affects how a baby lies in your womb. Uterus irregularities are relatively unusual. About 3 percent of women are born with a defect in the size, shape, or structure of their uterus. A bicornuate uterus is one of the most common types of uterine irregularities.

Read on to learn more about ways that doctors detect a bicornuate uterus and how this condition can impact your pregnancy.

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Symptoms

Symptoms

Women with a bicornuate uterus are born with it, but they might not know they have it unless they undergo an ultrasound or other imaging test. That’s because it often doesn’t cause any noticeable symptoms.

On the other hand, some women with a bicornuate uterus report the following symptoms:

If you have a bicornuate uterus, you’ve had it your whole life, so any potential symptoms might seem usual for you.

Pregnancy

Bicornuate uterus and pregnancy

A heart-shaped uterus probably won’t affect your fertility. In fact, studies have shown that having a bicornuate uterus doesn’t lessen a woman’s chances of becoming pregnant. But, some older research suggests that this abnormality is more common in women who are infertile.

A bicornuate uterus raises your risk of having a miscarriage later in your pregnancy and delivering your baby early. Some researchers suggest that these problems happen because of irregular uterine contractions or reduced uterine capacity.

Statistics vary when it comes to determining how many women experience these problems. For instance, one report states that the prevalence of repeated miscarriage in women with uterine defects ranges between 1.8 percent and 37.6 percent.

Additionally, babies born to mothers with a bicornuate uterus have a greater chance of developing birth defects compared to those born to women without the condition. In fact, this risk was four times higher in one study.

If you have a bicornuate uterus, your pregnancy will be treated as high-risk. Your doctor will monitor your pregnancy carefully. They may perform frequent ultrasounds to check the position of your baby.

Your baby may settle in a breech position, which means their bottom or feet are facing down before birth. You may require extra testing and will be more likely to give birth via Cesarean delivery.

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Causes

Causes

A bicornuate uterus is a congenital abnormality, which means it’s something a woman is born with. It happens when a baby girl’s uterus doesn’t develop normally in the womb. Special ducts only partially fuse together, which leads to separation of the two upper parts, or horns, of the uterus. When the horns stick out a little, the womb appears to be heart-shaped. You can’t prevent or stop this condition if you have it.

Diagnosis

Diagnosis

Doctors can use the following tests to diagnose a bicornuate uterus:

Most often, the condition is detected during an ultrasound that’s performed to look at your uterus during pregnancy or when you’re experiencing unwanted symptoms.

Many women are surprised to find out they have a heart-shaped uterus. Some will go their whole lives without knowing they have the condition.

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Treatment

Treatment

Surgery, called a Strassman metroplasty, can sometimes be used to correct a bicornuate uterus in women with a history of miscarriage. In one analysis, 88 percent of those who had a Strassman metroplasty achieved pregnancies that ended with a successful birth. However, the majority of women won’t need surgery to repair a bicornuate uterus.

Performing this procedure in women with a bicornuate uterus who experience infertility is controversial in the medical community. This is because most research suggests that the condition doesn’t affect a woman’s chances of becoming pregnant.

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Outlook

Outlook

Having a bicornuate uterus probably won’t affect your fertility. It could lead to problems such as miscarriage and early birth, though you may still be able to have a successful pregnancy and delivery.

It’s important to surround yourself with a good medical team that will monitor your pregnancy carefully. Don’t hesitate to ask your doctor about any concerns you might have.

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