A T-shaped uterus is a type of uterine anomaly that can raise questions about fertility and pregnancy. This specific uterine shape can influence a woman’s ability to conceive and carry a pregnancy to term.
What is a T-Shaped Uterus?
A T-shaped uterus is a congenital uterine malformation where the internal cavity resembles the letter “T”. This occurs due to abnormally thickened lateral walls and a narrowed, constricted uterine cavity. It is associated with in-utero exposure to diethylstilbestrol (DES), a synthetic estrogen.
Diagnosis often involves imaging techniques such as hysterosalpingography (HSG), magnetic resonance imaging (MRI), or 3D transvaginal ultrasound. Medical societies classify this condition as a dysmorphic uterus.
Impact on Conception
The altered anatomy of a T-shaped uterus can affect a woman’s ability to conceive. The narrow and constricted uterine cavity may hinder the normal movement of sperm towards the egg. The abnormal shape and reduced volume of the uterine cavity can interfere with embryo implantation.
For a fertilized egg to successfully implant and establish a pregnancy, it requires an adequately shaped and receptive uterine lining. The T-shape can limit the available surface area for implantation or create an environment less conducive to the embryo’s attachment and development in the uterine wall. This can lead to unexplained infertility or repeated implantation failures.
Pregnancy Risks
Once conception occurs, a T-shaped uterus can present several risks during pregnancy. The abnormal uterine shape is associated with a higher likelihood of early miscarriage and recurrent pregnancy loss. The reduced uterine volume and potentially altered blood supply within the malformed uterus can contribute to these adverse outcomes.
The condition also increases the risk of ectopic pregnancy, where the fertilized egg implants outside the uterus. Women with a T-shaped uterus face increased chances of preterm labor and delivery, intrauterine growth restriction (IUGR), and malpresentation, such as a breech position, which often necessitates a C-section.
Treatment and Outlook
For women with a T-shaped uterus experiencing fertility challenges or recurrent pregnancy losses, surgical intervention is an option. Hysteroscopic metroplasty is the main treatment to correct the uterine shape. This minimally invasive procedure involves surgically widening the constricted uterine cavity by making incisions in the thickened lateral walls, aiming to restore a more normal, triangular uterine shape and increase its volume.
The goal of hysteroscopic metroplasty is to improve both conception rates and the ability to carry a pregnancy to term. Studies have shown that this procedure can improve live birth rates and reduce miscarriage rates in women with a T-shaped uterus, particularly those with a history of primary infertility, recurrent miscarriages, or repeated implantation failures. While the data is accumulating, successful metroplasty can lead to live birth rates ranging from approximately 43% to 87.5%. Consulting with fertility specialists is important to determine the most appropriate course of action and to understand the potential benefits and risks of treatment.