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Born Unique: Should Doctors Always Fix a Different-Shaped Uterus?

Uterine shape is fairly classic, and usually described as egg-shaped. But some come in all sorts of sizes and shapes, mostly because of failures of fusions from the lower to the upper or the left to the right during fetal life. What is left may be a uterus shaped like a heart, or a double, or a half a heart. When the uterus is left with these shapes, the question is whether to correct, and, in fact, some of the oddest shapes just do not have the pieces and parts to correct. The first step is always to know what is there.

The medical term for these shapes are anomalies. Uterine anomalies can be diagnosed fairly accurately by ultrasound examination, and definitive pre-surgical diagnosis is actually not common. Often what is best is an actual look-see with a hysteroscope. Then a decision can be made at that setting, or at a separate step as to whether it can be or should be corrected.

Patients with history of menometarrhagia - in other words, bleeding heavily or for a long time, pelvic pain and/or miscarriages - may need corrections. Some experts would even still support this position and state that it is not an indicated surgery in someone with primary infertility unless the treatment of other aspects of the infertility did not result in pregnancy.

It has become more common for physicians to try to fix certain uterine abnormalities - for instance, if you have a septum, or dividing wall, hanging in the middle of the uterus where it doesn't belong - before the patient has medical troubles from this. Although I don't think I mention this enough in these writings, here would be a great opportunity for a second opinion or a sub-specialist opinion.


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