Uterine Abnormalities
The shape and structure of the uterus play an important role in fertility and pregnancy. Uterine abnormalities refer to congenital or acquired conditions that affect the anatomy of the uterus. Some of these structural differences can interfere with implantation, increase the risk of miscarriage, or make it harder to carry a pregnancy to term.
Many uterine abnormalities are treatable—and once identified, your care team can recommend the best path forward based on your diagnosis and family-building goals.
What are uterine abnormalities?
Uterine abnormalities fall into two main categories:
- Congenital abnormalities: These are present from birth and result from the uterus developing differently in the womb. Examples include:
- Septate uterus: A band of tissue divides the uterus, partially or completely
- Bicornuate uterus: The uterus has two horns, shaped like a heart
- Unicornuate uterus: A single-sided uterus with only one fallopian tube
- Didelphic uterus: Two separate uterine cavities and often two cervices
- MRKH syndrome: A condition where the uterus and upper vaginal canal are underdeveloped or absent, despite normal ovarian function and external anatomy
- Acquired abnormalities: These develop later in life and may include:
- Intrauterine adhesions (Asherman’s syndrome): Scar tissue inside the uterus, often caused by prior surgery or infection
- Fibroids or polyps that distort the uterine cavity
Some people may not have any symptoms, while others experience irregular bleeding, pelvic pain, or repeated pregnancy loss.
What causes uterine abnormalities?
Congenital abnormalities result from differences in how the uterus forms during fetal development. These changes aren’t preventable or caused by anything during adulthood.
Acquired abnormalities may be related to:
- Uterine surgery (such as D&C or fibroid removal)
- Pelvic infection
- Hormonal conditions that promote the growth of fibroids or polyps
Most structural differences go undetected until imaging or fertility testing is performed.
How uterine abnormalities affect fertility
The impact on fertility depends on the type and severity of abnormality. Common issues include:
- Disruption of the uterine cavity making it harder for an embryo to implant
- Increased risk of miscarriage, especially with septate or scarred uterine walls
- Impaired blood flow affecting the uterine lining and embryo development
- Abnormal uterine contractions, which can interfere with early pregnancy
Not all abnormalities require treatment—but for those that do, options are often effective.
How uterine abnormalities are diagnosed
Fertility specialists use advanced imaging to assess the shape and condition of the uterus. Common diagnostic tools include:
- Saline sonohysterogram (SIS): Ultrasound with saline infusion to evaluate the uterine cavity
- Hysterosalpingogram (HSG): X-ray imaging that uses contrast dye to visualize the uterus and fallopian tubes
- MRI: Used in complex cases for detailed structural evaluation
- Hysteroscopy: A minimally invasive procedure that allows direct visualization of the uterine cavity
Accurate diagnosis helps determine whether an abnormality is impacting fertility and whether treatment is recommended.
Treatment options for uterine abnormalities
Treatment depends on your diagnosis, symptoms, and reproductive goals. Options may include:
- Hysteroscopic surgery: Minimally invasive removal of uterine septum, adhesions, polyps, or submucosal fibroids
- Laparoscopic or robotic surgery: Used for more complex congenital conditions
- IVF: May be used to bypass anatomical barriers or improve success after surgical correction
- Gestational carrier: Recommended in cases where carrying a pregnancy is not possible or medically advised, such as with MRKH syndrome
Your IVF Florida care team will create a personalized plan based on your unique anatomy, goals, and fertility timeline.
Dr. Gualtieri communicates clearly and answers all questions patiently. I never walk away wondering about additional details. He just seems like an extremely normal guy and makes you feel at ease in an new and scary situation.