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Writer's pictureSabapathy J

Uterine Anomalies: Understanding, Diagnosing, and Managing Fertility Challenges at Paul’s Hospital



At Paul’s Hospital, we understand that every woman's journey to motherhood is unique, and sometimes, structural issues within the uterus—known as uterine anomalies—can create unexpected hurdles. These anomalies can impact fertility, cause recurrent miscarriages, or complicate pregnancy, but with advanced care and compassionate support, many women can overcome these challenges. Let’s explore the types of uterine anomalies, how they are diagnosed, and the expert solutions available at Paul’s Hospital.


What Are Uterine Anomalies?

Uterine anomalies refer to irregularities in the size, shape, or structure of the uterus. They can be present at birth (congenital) or develop later (acquired). While some women experience no symptoms, others may face fertility issues, painful periods, or pregnancy complications.


Types of Uterine Anomalies

Congenital Uterine Anomalies:

These develop during foetal growth due to improper formation or fusion of the Müllerian ducts, which form the female reproductive tract. Common types include:

  • Septate Uterus: A fibrous band divides the uterus, often linked to miscarriages.

  • Bicornuate Uterus: A heart-shaped uterus with two cavities, potentially affecting implantation.

  • Unicornuate Uterus: Only one side of the uterus develops fully, resulting in a smaller cavity.

  • Uterus Didelphys: Two separate uteri, sometimes each with its own cervix.

  • Hypoplastic or Absent Uterus: A rare condition where the uterus is underdeveloped or missing.

  • Hypoplastic cervix or absent cervix: A rare condition where cervix is underdeveloped or missing

  • Absent vagina: A rare condition where vagina has not developed

Acquired Uterine Anomalies:

These develop later in life due to factors like surgery, infection, or hormonal changes. Examples include:

  • Asherman’s Syndrome: Scar tissue inside the uterus, often following surgery.

  • Adenomyosis: Endometrial tissue growing into the uterine wall, causing pain and heavy bleeding.

 

Symptoms to Watch For

Symptoms vary but can include:

  • Absence of menses even after the age of menarche

  • Heavy or irregular menstrual bleeding

  • Severe menstrual cramps or pelvic pain

  • Recurrent miscarriages or difficulty conceiving

  • Pain during intercourse

  • Premature labour or pregnancy complications


Expert Diagnosis at Paul’s Hospital

Diagnosing uterine anomalies is crucial for effective treatment and successful pregnancies. At Paul’s Hospital, we use advanced diagnostic tools to provide accurate assessments:

  1. Medical History & Physical Exam: Personalised consultations to understand your symptoms and medical history.

  2. Advanced Imaging:

    • 3D Ultrasound: Offers detailed views of uterine structure.

    • MRI: Provides clear, detailed images for complex cases.

  3. Hysterosalpingography (HSG): Uses dye and X-rays to examine the uterine cavity and fallopian tubes.

  4. Hysteroscopy & Laparoscopy: Minimally invasive procedures to directly visualise and assess the uterus.


How Uterine Anomalies Affect Fertility

Structural abnormalities can impact fertility in various ways:

  • Ammenorhoea : A girl may fail to menstruate even after attaining the age of menarche

  • Implantation Issues: Anomalies like a septate uterus may prevent embryos from attaching.

  • Recurrent Miscarriages: Reduced space or blood supply can hinder embryo development.

  • Pregnancy Complications: Abnormal shapes can cause preterm labour or affect foetal growth.


Personalised Treatment at Paul’s Hospital

Every woman’s needs are unique, and so are our treatment plans. Our multidisciplinary team offers:

Surgical Solutions:

  • Hysteroscopic Resection: Removes septa, polyps, or small fibroids.

  • Metroplasty: Reconstructs the uterus to create a single cavity, enhancing fertility.

  • Myomectomy: Removes fibroids while preserving the uterus.

  • Adhesiolysis: Clears scar tissue for conditions like Asherman’s Syndrome.

  • Reconstruction of vagina : For women with absent vagina

Medications:

  • Hormonal Therapy: Manages symptoms and regulates cycles.

  • GnRH Agonists: Reduce fibroid or adenomyosis size before surgery.

Assisted Reproductive Technologies (ART):

  • IVF: Provides hope for those with severe anomalies.

  • Surrogacy: An option for women with absent or non-functional uteri.


Support Beyond Treatment

At Paul’s Hospital, we go beyond medical care:

  • Emotional Support: Fertility challenges can be emotionally taxing. Our counsellors are here for you.

  • Holistic Wellness: Diet, exercise, and stress management programs to support your overall well-being.


Hope and Healing at Paul’s Hospital

Facing uterine anomalies can be daunting, but you’re not alone. At Paul’s Hospital, we combine medical expertise, advanced technology, and compassionate care to help you navigate your fertility journey. Our dedicated team is committed to finding the best solutions tailored to your needs, empowering you to achieve your dream of motherhood.

Your journey begins here. Trust Paul’s Hospital—where your health, hope, and future are in expert hands.

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