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Reproductive medicine

Reproductive medicine

What are anomalies of the reproductive tract?
  • Anomalies are congenital disruptions of reproductive organs.
What leads to anomalies of the reproductive tract?
  • They are developed due to aberrations in the development of the Müllerian ducts which are formed in week 5 of embryogenesis.
How common are anomalies of the reproductive tract?
  • Around 1% of women suffer from them.
How are anomalies of the reproductive tract diagnosed?
  • During pelvic examination,
  • Using 3D ultrasound,
  • Using hysterosalpingogram,
  • By magnetic resonance imaging (MRI),
  • By laparoscopy.
What types of reproductive tract anomalies are there?
  • Hypoplasia or agenesis of the uterus – when the uterus does not develop at all.
  • Unicornuate uterus – the uterus develops from a single Müllerian duct while the other atrophies.
  • Uterus didelphys or double uterus – when both Müllerian ducts develop but do not connect.
  • Bicornuate uterus – only the upper portions of Müllerian ducts are connected and the uterus is heart-shaped.
  • Septate or arcuate uterus – two Müllerian ducts are partially connected and a midline septum is developed.
What are the symptoms in women with reproductive tract anomalies?
  • the symptoms depend on the type of the anomaly:
    • Hypoplasia or agenesis – primary amenorrhea, pregnancy is possible only through surrogacy.
    • Unicornuate uterus – usually no symptoms until pregnant. Miscarriages, premature birth and pregnancy complications are often.
    • Uterus didelphys or double uterus – usually no symptoms until pregnant. Miscarriages, premature birth and pregnancy complications are often.
    • Bicornuate uterus – usually no symptoms until pregnant. Miscarriages, premature birth and pregnancy complications are often.
    • Septate or arcuate uterus – usually no symptoms until pregnant. Miscarriages, premature birth and pregnancy complications are often.
Do the anomalies of the reproductive tract cause problems in pregnancy?
  • A smaller septum is considered to cause more severe complications in pregnancy than larger anomalies of the uterus.
How are anomalies of the reproductive tract treated?
  • Usually, no treatment is necessary, but a more intensive monitoring of pregnancy is.
  • Surgically (depending on the type of the anomaly) by
    • Laparoscopy,
    • Hysteroscopy,
    • Open surgery.