Can women with uterine malformations become pregnant?
Jun 10, 2022
Source: Cainiu Health
Dr. Chong Yiwen
Introduction
In general, uterine malformations do not impede conception but may affect fetal development. A double uterus is rare, yet successful pregnancy remains possible. A unicornuate uterus—where only one horn develops and the ovary connects to the corresponding side of the uterus—may also support a successful pregnancy if uterine development is otherwise normal. A bicornuate uterus is relatively common and typically does not interfere with pregnancy. Uterine hypoplasia refers to underdevelopment of the uterus, which may result in an extremely small uterus or even complete absence of the uterus, rendering normal pregnancy impossible.
In most cases, uterine malformations do not prevent conception but may affect fetal development. Specific types include the following:
① Uterus Didelphys
Uterus didelphys features two separate uterine cavities, each with its own cervix and vaginal canal. Although this anomaly is rare, successful pregnancy remains possible.
② Unicornuate Uterus
A unicornuate uterus results from incomplete development of the uterus during early embryogenesis. Women with this condition typically have two ovaries, but only one is connected to the uterus. Nevertheless, if the unicornuate uterus develops normally, pregnancy may still occur successfully.
③ Bicornuate Uterus
A bicornuate uterus is a relatively common uterine malformation that generally does not impede conception. However, compared with a normal uterus, the intrauterine space available for fetal growth is reduced, increasing the likelihood of breech presentation (i.e., fetus positioned feet- or buttocks-first) rather than the typical cephalic (head-down) position—often necessitating cesarean delivery.
④ Hypoplastic or Aplastic Uterus
Hypoplastic or aplastic uterus occurs when vaginal development is abnormal or severely underdeveloped, resulting in an extremely small or absent uterus. This condition is often diagnosed when menarche is significantly delayed. Pregnancy is not possible in cases of complete uterine aplasia or severe hypoplasia.
