Can women with uterine malformations become pregnant?
Jul 06, 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 pregnancy but may affect fetal development. Specific types are described below:
① Uterus Didelphys (Double Uterus)
Uterus didelphys features two separate uterine cavities, each opening into its own cervix and vagina. Although this anomaly is rare, successful pregnancy remains possible.
② Unicornuate Uterus (Single-Horned Uterus)
A unicornuate uterus results from incomplete development of the Müllerian ducts 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 (Double-Horned 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 (fetus positioned feet- or buttocks-first) rather than the typical cephalic (head-down) position—often necessitating cesarean delivery.
④ Hypoplastic or Aplastic Uterus
Hypoplasia or aplasia of the uterus may occur when vaginal development is abnormal or severely underdeveloped (e.g., extremely short vagina). In such cases, the uterus may be markedly underdeveloped or entirely absent. This condition is often first identified when menarche is significantly delayed. Pregnancy is not possible in cases of complete uterine aplasia or severe hypoplasia.
