Didelphic Uterus: Signs, Causes and Treatment

A didelphic uterus, also known as a double uterus, is a condition where a woman has two separate uteri instead of one. This rare congenital anomaly occurs during fetal development when the uterus fails to properly fuse into a single organ. As a result, a woman with a didelphic uterus has two separate cavities within the uterus, each with its own cervix.

This anatomical variation can sometimes be associated with other reproductive system abnormalities but does not typically cause symptoms on its own. The exact cause of this condition is not always clear, but it is believed to be due to disruptions in the normal development of the female reproductive system during embryogenesis. While a didelphic uterus is uncommon, it can be identified through

What Are the Symptoms of Didelphic Uterus?

A didelphic uterus may present with symptoms like irregular periods, severe menstrual cramps, pelvic pain, and difficulty getting pregnant. Some individuals may also experience recurrent miscarriages or preterm labor. Additionally, there could be challenges during childbirth due to the abnormal uterine structure.

It's important to consult with a healthcare provider if you experience any unusual symptoms or have concerns about your reproductive health to receive proper evaluation and management.

Didelphic uterus may present with pelvic pain due to the abnormal shape of the uterus.
Some individuals with didelphic uterus may experience heavy or irregular menstrual bleeding.
Infertility issues can occur in women with didelphic uterus due to structural abnormalities affecting the reproductive system.
Recurrent miscarriages may be a symptom of didelphic uterus, impacting the ability to carry a pregnancy to full term.
Didelphic uterus can sometimes lead to urinary tract infections or other urinary symptoms due to the proximity of the uterus to the bladder.

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Causes of Didelphic Uterus

Factors contributing to this condition may include genetic predisposition, hormonal imbalances, or environmental influences. While the exact cause is not always clear, disruptions in the intricate process of embryonic differentiation can lead to the formation of two separate uterine horns instead of a single uterus. Understanding these underlying factors can help in diagnosing and managing didelphic uterus effectively.

Genetic factors can play a role in the development of a didelphic uterus.
Hormonal imbalances during fetal development may lead to the formation of a didelphic uterus.
Intrauterine exposures to certain environmental toxins or medications could contribute to the presence of a didelphic uterus.
Structural abnormalities during embryonic development might result in a didelphic uterus.
Rare conditions such as Mullerian duct anomalies can be associated with the presence of a didelphic uterus.

Types Of Didelphic Uterus

There are two main types of didelphic uterus based on the structure of the cervix: complete didelphic uterus, where each uterine cavity has a separate cervix, and incomplete didelphic uterus, where the two uterine cavities share a single cervix. This condition can sometimes be associated with reproductive issues such as infertility or recurrent miscarriages. Treatment options depend on individual circumstances and may include surgical interventions to correct any abnormalities that could affect fertility or pregnancy.

Complete didelphic uterus: Also known as a complete double uterus, this type presents as two separate uterus cavities with individual cervixes and sometimes even two vaginas.
Incomplete didelphic uterus: In this variation, there is a partial division of the uterus with a single cervix but a partial septum inside the uterus separating the two cavities.
Didelphic uterus with double cervix: Some individuals with a didelphic uterus may have two separate cervixes in addition to the duplicated uterus structures.
Didelphic uterus with single cervix: While less common, a didelphic uterus can also occur with a single cervix connecting the two uterine cavities.

Risk Factors

Didelphic uterus, a rare congenital anomaly where a woman has two separate uterine cavities, can be influenced by various risk factors. These factors may include genetic predisposition, hormonal imbalances during fetal development, exposure to certain environmental toxins or medications, and maternal age at the time of conception. Additionally, conditions such as Müllerian duct anomalies or certain reproductive tract infections may also contribute to the development of a didelphic uterus. Understanding and identifying these risk factors can be crucial in managing the condition and potential associated complications.

Family history of didelphic uterus increases the risk of inheriting the condition from close relatives.
Exposure to certain environmental toxins during fetal development may contribute to the development of a didelphic uterus.
Hormonal imbalances, such as those related to polycystic ovary syndrome (PCOS), can be a risk factor for didelphic uterus.
Congenital disorders affecting the reproductive system, like Müllerian duct abnormalities, can predispose individuals to a didelphic uterus.
Previous pelvic infections or surgeries may lead to scarring and structural abnormalities, potentially increasing the risk of a didelphic uterus.

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Diagnosis of Didelphic Uterus

A transvaginal ultrasound is commonly used to visualize the reproductive organs and identify any abnormalities in the uterus structure. Additionally, a magnetic resonance imaging (MRI) scan may provide more detailed information about the uterine anatomy.

In some cases, a hysterosalpingogram, which involves injecting dye into the uterus and fallopian tubes, can help detect any issues with the uterine cavity. These diagnostic tests, along with a thorough medical history and pelvic exam, play a crucial role in confirming the presence of a didelphic uterus and guiding further treatment decisions.

Didelphic uterus may be diagnosed through imaging tests such as ultrasound or MRI to visualize the abnormal uterine structure.
Hysterosalpingography (HSG) can help identify the presence of two separate uterine cavities in a didelphic uterus.
Diagnostic laparoscopy may be performed to directly visualize the uterine anomaly and assess the reproductive implications.
Medical history and physical examination, including pelvic exams, can provide clues to the presence of a didelphic uterus.
In some cases, genetic testing may be recommended to assess for any associated congenital abnormalities or syndromes.

Treatment for Didelphic Uterus

Treatment options for didelphic uterus depend on the individual's symptoms and reproductive goals. In cases where the condition is asymptomatic and does not affect fertility, no treatment may be necessary. However, for those experiencing issues such as recurrent miscarriages or pelvic pain, management options may include hormonal therapy to regulate menstrual cycles, surgical interventions to correct anatomical abnormalities, such as septum resection or uterine reconstruction, or assisted reproductive technologies to improve the chances of conception. It is essential for individuals with a didelphic uterus to work closely with their healthcare provider to determine the most appropriate treatment approach based on their unique circumstances and goals.

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