Bicornuate uterus and chances of pregnancy

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Uterine malformations are anatomical variations of the uterus that develop before birth. Although there are different types of malformations, today we focus on the bicornuate uterus and the chances of achieving pregnancy with Dr. Daniel Bodri.

dr daniel bodri expertos en reproduccion asistida

What is the bicornuate uterus?

Known as the “heart-shaped uterus” it is a congenital anomaly of the uterus, where the uterus has two cavities separated by division.

In the bicornuate uterus, unlike a septate uterus, there is a complete malformation of both the internal and external structure, affecting all three uterine layers: endometrium, myometrium and perimetrium.

This condition results in a uterus with two cavities, whose appearance and structure are abnormal.

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Bicornuate uterus classification according to ESHRE:

Differentiating between the types of bicornuate uterus is crucial to understanding its impact on fertility and pregnancy.

Depending on the extent of the central fold (degree of separation between the two cavities), the bicornuate uterus can be classified as:

  • Partial bicornuate uterus
  • Complete bicornuate uterus
  • Septate bicornuate uterus

These differences are fundamental to determine the most appropriate approach to care and treatment in the quest for motherhood.

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How is it diagnosed?

Uterine malformations such as bicornuate uterus are usually identified through ultrasound scans and may require additional tests for a complete evaluation, such as pelvic MRI and laparoscopy.

  • Pelvic MRI: collects detailed images of the pelvic area, allowing for accurate classification of uterine malformations.
  • Laparoscopy: is an invasive procedure that, under general anaesthesia, introduces a camera into the abdomen to directly observe the uterus and verify if the external cleft corresponds with the internal one, providing a clear view of the condition.

Bicornuate uterus and its impact on fertility and pregnancy

The bicornuate uterus can influence fertility and pregnancy, however, although many women with this condition manage to conceive without medical intervention, the main concern arises during pregnancy.

In pregnancy, the risk of miscarriage and premature delivery is increased due to the abnormal shape of the uterus, which may not expand adequately to accommodate foetal growth.

Medical supervision is essential to identify and manage possible complications as it is a risky pregnancy. In some cases, specific treatment, such as surgery, may be recommended to improve the chances of a successful pregnancy.

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Treatments and follow-up of the bicornuate uterus

Options for managing conception and pregnancy in women with a bicornuate uterus include:

  1. Monitoring and follow-up: Careful monitoring of the pregnancy to detect and manage possible complications.
  2. Preconception counselling: Detailed assessment to understand the risks and prepare a personalised plan.
  3. Assisted reproductive techniques: Use of procedures such as IVF to increase the chances of conception.
  4. Pregnancy support: Monitoring of foetal growth and consideration of scheduled delivery, if necessary.
  5. Surgical intervention: In some cases, surgical correction may be considered to improve the chances of pregnancy and reduce the risk of complications.

It is important for women with a bicornuate uterus to consult with a fertility specialist to discuss the best options for their specific case.

“Understanding these malformations is crucial to properly manage the associated risks and seek the most effective strategies to achieve a healthy pregnancy,” says Dr Daniel Bodri.

Advice for women with a bicornuate uterus and pregnancy

According to Dr Daniel Bodri, to maximise the chances of a healthy pregnancy with a bicornuate uterus, the following recommendations should be followed:

  • Consultation with a specialist: Before trying to conceive, it is essential to consult a gynaecologist specialising in fertility to assess your specific situation and receive personalised advice.
  • Medical follow-up during pregnancy: To monitor foetal development and detect any complications early.
  • Healthy lifestyle: Maintain a balanced diet, avoid the consumption of harmful substances, and exercise moderately, always under medical supervision.
  • Emotional support: Consider seeking emotional support through therapy or support groups to manage the stress and worries associated with fertility and pregnancy.

It is important to remember that each case is unique, and it is best to follow the specific recommendations of an assisted reproduction specialist.

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