A heart-shaped womb may sound picturesque and endearing but in fact it can sometimes, but not always, lead to problems. This is the common term for a bicornuate uterus, a condition in which the womb is literally heart-shaped as opposed to its normal form, often likened to an inverted pear. A heart-shaped womb during pregnancy can cause some difficulties but on the other hand many people have successful and trouble-free pregnancies without ever being aware that they have one.
In this IVI blog article, we take you through the related issues that could affect you. How you would know if you had the condition, what causes it and the potential hazards of a heart-shaped womb in pregnancy. We also address the question of whether, if you have a heart-shaped womb, miscarriage is more likely and whether there are any other heart-shaped womb problems you should be aware of.
How would you know if you had a heart-shaped womb?
Uterus irregularities are relatively unusual: about 3 percent of women are born with an abnormality in the size, shape, or structure of their uterus. A bicornuate uterus is one of the most common types of these irregularities. One of the only methods by which you could be certain of having this condition would be through a 3D ultrasound scan or a magnetic resonance imaging scan (MRI). Usually there would be no reason to have this procedure carried out except in the case of recurrent miscarriages. The other circumstance would be if you visit an assisted fertility clinic due to fertility problems.
For example, at IVI clinics, we would initially undertake diagnostic testing for infertility. This would include a hysterosalpingography. This technique uses fluoroscopy, a form of x-ray, to examine the uterus and fallopian tubes when a woman is experiencing infertility for unexplained reasons. It can also be used to investigate miscarriages resulting from uterine abnormalities and fibroids. The procedure itself can at times have the effect of unblocking the fallopian tubes to allow the woman to become pregnant naturally afterwards.
What causes a heart-shaped womb?
A heart-shaped womb is a congenital abnormality, which means it’s something a woman is born with and not something that develops over time. It happens when a baby girl’s uterus doesn’t develop normally in the womb. This distinguishes it from a genetic condition, meaning that it is not inherited and neither is it going to be passed on genetically to future daughters. What happens during development of the female foetus in this condition is that the ducts that form the womb only partially fuse together, which causes a separation of the two upper sections, or horns, of the uterus. When the horns stick out a little, the womb appears to be heart-shaped.
What happens during pregnancy if you have a heart-shaped womb?
The probability is that a bicornuate uterus will not affect your fertility and will not have a detrimental effect on your chances of becoming pregnant. However, the most common problems arising from a heart-shaped womb during pregnancy are recurrent miscarriages, preterm (or premature) birth and the possibility of a breech delivery. (This is when the baby comes out bottom first or feet first rather than the normal head first.)
Does a heart-shaped womb make miscarriage more likely?
A heart-shaped womb in pregnancy does raise the risk of miscarriage later in the pregnancy and also the risk of a premature birth. Some medical practitioners believe that these occurrences happen as a result of irregular contractions of the uterus, or because of the reduced womb capacity resulting from its abnormal shape. There are no reliable statistics on the percentage of women likely to experience these problems, with estimates ranging from just under 2% to almost 37%. Nevertheless, the other side of these figures shows that the likelihood of these problems not occurring is well over 50%.
It is also not clear why this abnormality causes problems such as miscarriage, breech birth or premature birth. A general supposition is that the malformed uterus may, in some instances, restrict the growth of the developing foetus.
Of course, the potential for this type of complication means that your pregnancy will be treated as high risk and will be closely monitored. If you do have the condition, your medical advisor may arrange for ultrasound checks to be performed fairly frequently to check the position of your baby. If it has settled into a breech position, it will be likely that you will need to give birth by caesarean section.
Are there any other heart-shaped womb problems?
Many women go their whole lives without even knowing that they have a heart-shaped uterus. It’s usually asymptomatic, so in the absence of problems there is really no reason why you would ever know. It generally has no effect on your periods and your menstrual cycle functions as normal. Apart from the potential for complications from a heart-shaped womb in pregnancy, in some cases people do experience other heart-shaped womb problems.
In rare cases, this condition may put you at a higher risk of endometriosis. This is a common condition in which tissue that behaves like the lining of the womb (the endometrium) is located outside the womb. These pieces of tissue can lodge in many areas including the ovaries and fallopian tubes, the lining of the abdomen and in the bowel or bladder. The condition is estimated to affect around one in 10 women, so is far from rare. It is a chronic (i.e. long-term) condition in which symptoms vary widely from person to person, and some women have no symptoms at all. The most common symptoms when they do occur include heavy or painful periods, pain in the pelvis, lower back or lower abdomen and sometimes bleeding between periods.
We would stress however that if you experience endometriosis it does not necessarily signify that you have a heart-shaped womb and conversely, if you do have one, you will not necessarily suffer from endometriosis.
Finding out more about a bicornuate uterus and pregnancy
If you have any concerns at all about your fertility, it’s always a good idea to have a diagnostic check-up which could either identify any problems or give you the all-clear to carry on trying without any worries! We would encourage anyone thinking of making a visit to an IVI clinic to browse our website for all the up-to-the-minute information about the diagnostic tests and techniques we offer and our treatments.
You can also find out about our success rates and research them for yourself. In general, you will find it reassuring to know that IVI is one of the European centres with the highest pregnancy rates. In fact, 9 out of 10 couples who consult IVI due to problems with infertility and who put their trust in us reach their goal. Of course, the effectiveness of assisted reproduction treatments varies depending on the technique chosen and the reproductive prognosis of the patients. But with all the various techniques at our disposal, IVI assisted reproduction clinics have an accumulated pregnancy rate of close to 97% over three attempts. You can check our audited clinical results here and see for yourself.
Your first visit to IVI: what to expect
It could also be helpful for you to know what to expect when you first make an appointment with IVI. At your first visit to any of our assisted reproduction clinics the doctor begins with a review of your medical record, your reproductive history and any treatments that you have received or are currently undergoing. He or she will then be able to recommend what additional tests are advisable, and whether a gynaecological examination is necessary.
The measures for diagnosing infertility include a complete medical history work-up and physical examination of both members of the couple. In the case of the woman, the basic tests are a basal hormone study, an ultrasound scan and, as we mentioned above, a hysterosalpingography which is the test that can diagnose a heart-shaped womb or any other uterine abnormality. The range of tests can be extended depending on individual circumstances. To complete the diagnosis it is also necessary to assess semen quality in the man with a seminogram test.
When you feel the time is right, do get in touch with us for a first appointment. You can give us a call on 08 000 850 035 from the UK or on +34 960 451 185 from other countries. Alternatively simply complete our online contact form, without any obligation, and a specialist will call you. You can also arrange your first appointment with a gynaecologist at your nearest IVI clinic.