Unicornuate uterus is a rare condition in which the uterus is only partially developed. People with a unicornuate uterus may only have one fallopian tube. Their uterus is smaller and differently shaped than a typical uterus.
The condition doesn’t lead to general health issues. Having a unicornuate uterus can be a concern during menstruation and pregnancy, but you can still have children despite the condition.
Formation of Unicornuate Uterus
Unicornuate means "one horn" and describes a uterus that doesn't have a typical two-horned shape. This is why the condition is also called unicorn uterus. A unicornuate uterus develops when you are still an embryo. Typically, an embryo will develop two structures called Mullerian ducts. These are tubes that usually grow to become the fallopian tubes and uterus. They form symmetrically and connect to form a uterus, which looks almost heart-shaped.
In the case of a unicornuate uterus, there may be two Mullerian ducts, but one is underdeveloped. Instead of connecting into a single organ, one duct develops into a banana-shaped partial uterus with one fallopian tube.
Some people with a unicornuate uterus may also have a remnant uterus called a hemi-uterus that may separate from the more fully formed uterus. A hemi-uterus may have its own cervix but it probably won't connect to the vagina. It might develop a uterine lining for menstruation, but it cannot release the lining out of the body. This can lead to severe pain during menstruation.
The hemi-uterus is usually surgically removed. If a pregnancy starts in this second, unformed uterus, it is considered a medical emergency similar to an ectopic pregnancy. In an ectopic pregnancy, the embryo starts developing on the fallopian tube. If an ectopic pregnancy isn't terminated, the tube can rupture and lead to hemorrhage, infection, or death. A pregnancy in a hemi-uterus can have the same risks. Your doctor will tell you what steps you need to take to protect your health in this situation.
There is no known cause for an unicornuate uterus. It’s a genetic abnormality but doesn’t run in families. There is no way to prevent it and no known risk factors for it happening. Experts estimate that it affects 1 in 4,020 females.
What Are the Symptoms of Unicornuate Uterus?
Children born with a unicornuate uterus don’t usually have any symptoms before puberty. In some cases, they will also have other health concerns, such as kidney issues. Doctors may discover the unicornuate uterus while treating those conditions.
More often, the unicornuate uterus is diagnosed when a teenager has pain or discomfort with menstruation, if there is a hemi-uterus alongside the unicornuate uterus. Other people discover they have a unicornuate uterus when they want to have a baby. They may have difficulty conceiving due to the unusual shape of their uterus. Once they do get pregnant, they might discover their unicornuate uterus during a routine ultrasound.
Can You Have a Baby With Unicornuate Uterus?
Many people with unicornuate uteruses can have babies.
If you have a functional ovary, fallopian tube, and uterus, you may be able to conceive without assistance. If you and your partner have difficulty conceiving, you may want to consider assisted reproductive technology (ART). Treatments like intrauterine insemination (IUI) or in vitro fertilization (IVF) might help you conceive a child.
Once you are pregnant, you should plan to get regular prenatal care. Your pregnancy may be considered complicated or high-risk. Your doctors will carefully monitor the progress of your pregnancy.
A unicornuate uterus is smaller than a typical uterus, and the shape is different, as well. It's narrower, leaving less space for a developing fetus. This can lead to some possible pregnancy complications, including:
- Miscarriage
- Preterm labor
- Breech positioning
- C-section
Other Considerations
If you are unable to conceive or carry a pregnancy to term, there are other options for creating a family. Adoption is one way people bring children into their lives. Others find that being a foster parent is a fulfilling way of helping children in need.
If your state allows it, you might consider gestational surrogacy. You can arrange to have an embryo conceived in a lab using your eggs and your partner’s sperm. Then another individual carries the pregnancy and delivers the baby. You and your partner will be the parents after the birth.
Your doctor can help you decide the best way to have children.