What is Arcuate Uterus

An arcuate uterus is a congenital uterine malformation in which the top part of the uterus is slightly indented.

The uterus usually resembles an upside-down pear. When you have an arcuate uterus, your uterus is not rounded or straight at the top and instead has a dent in the top portion. Generally, it is considered a normal variation of the uterus.

A study reports that an arcuate uterus is quite prevalent, i.e., around 11.8 per cent of women have an arcuate uterus. According to the American Fertility Society (AFS), an arcuate uterus is a genetic mullerian anomaly that does not impose much influence on the reproductive potential of a woman.

However, there can be a definite adverse impact on the course of your pregnancy due to complications caused by a severe arcuate uterus.

According to a study, the Arcuate Measure classifies an arcuate uterus into three categories of levels:

• Mild arcuate: The indentation lies between 0 and 0.5 cm
• Moderate arcuate: The indentation is more than 0.5 cm and less than 1 cm
• Severe arcuate: The indentation is more than 1 cm and less than 1.5 cm

Causes of an arcuate uterus

An arcuate uterus is a genetic defect. It develops because of a Mullerian duct anomaly.

Typically, when you are still an embryo in the womb, the developing embryo forms two Mullerian ducts. A uterus and two functioning fallopian tubes grow from these Mullerian ducts when they unite symmetrically.

But in the case of an arcuate uterus, though there are two Mullerian ducts, they fail to combine. And this, in turn, leads to failure in resorption of the uterovaginal septum (a septum which causes a gap or divides the uterus into two parts).

Hence, there is a dent in the top part of the uterus where the ducts fail to fuse.

Symptoms of an arcuate uterus

Usually, you will not experience symptoms like severe abdominal pain, miscarriages, etc., with a mild or moderate level of an arcuate uterus. You probably won’t even realise that you have an arcuate uterus until you go for imaging tests like an ultrasound.

However, if you have a severe level of an arcuate uterus, you may experience the arcuate uterus symptoms manifested in various forms. You can experience painful menstruation and difficulty in conceiving.

Research reveals that because of an arcuate uterus, you can have excessive uterine bleeding and a relatively lower term delivery rate. Moreover, a study suggests that you are susceptible to a higher risk of miscarriages in your second trimester, preterm labour, and other pregnancy complications due to an arcuate uterus pregnancy.

How do you know if you have an arcuate uterus?

Generally, a person with an arcuate uterus does not show any symptoms and the condition goes unnoticed. However, in the routine test for infertility, an arcuate uterus can be diagnosed. To get a clear picture of the condition and to initiate suitable treatment, an expert may recommend a few diagnostic tests such as – 

• 3D Ultrasound

• MRI Scan

• Hysterosalpingography

• Laparoscopy

Treatment of an arcuate uterus

Before moving on to the treatment, a diagnosis is essential to confirm an arcuate uterus and its severity level.

A doctor may inquire about your health history and recommend a pelvic examination. Besides that, your doctor may recommend the following imaging tests to check for an arcuate uterus.

– 3D Ultrasound

An arcuate uterus ultrasound is used to get a detailed picture of your uterus. In this imaging test, a sonographer applies gel to your abdomen and glides a hand-held scanner (transducer) across your skin.

A doctor can also request a transvaginal ultrasound to obtain a more thorough picture of your uterus. It will entail inserting a sterile transducer that is only slightly wider than a finger into your vagina. Though this will not hurt, it can feel unpleasant.

– MRI scan

A radiographer performs the MRI scan. You are required to lie still on a flatbed as it gently travels through a big scanner. It doesn’t hurt at all and lasts a little over an hour.

Sometimes, a particular sort of dye injection may be suggested by your radiographer to enhance the visibility of tissues and blood vessels during this imaging process.

– Hysteroscopy

Hysteroscopy is a surgical procedure that avoids making incisions on your body and is most often used to reconstruct the uterine cavity using natural channels. Such a procedure increases the likelihood of pregnancy and its typical course.

A tiny camera is inserted through the cervix and into the uterine cavity to get a comprehensive look at the entire uterus.

During this process, the doctor can assess the uterus’s morphology and any other anomalies, including an arcuate uterus.

– Hysterosalpingography

In this test, an X-ray is obtained after inserting a special dye into your fallopian tubes and womb using a small tube (catheter).

– Laparoscopy

This test enables a physician to access the interior of your abdominal cavity. The uterus, fallopian tubes, and ovaries are visible for assessment due to an abdominal wall camera insertion.

After your diagnosis turns out to be positive for an arcuate uterus and the level is mild or moderate, it will not cause any trouble, and there is no need for an arcuate uterus treatment.

– Hormone therapy

In case of a severe level of an arcuate uterus, hormone therapy is recommended. And when you finally become pregnant with a severe arcuate uterus, you should be careful when opting for a delivery method, as otherwise, it can cause complications during childbirth.

Moreover, your medical care team will discuss your birth alternatives with you if your baby ends up in an uncomfortable position in the later stages of pregnancy (such as lying throughout your uterus or lying bottom first). The most appropriate option for delivery will be a caesarean section.

You will need to be closely monitored at all times to prevent a miscarriage.

– Surgery

The surgical method of treatment for an arcuate uterus is used only when the composition of the arcuate uterus is the root cause of recurrent miscarriages and infertility.

Conclusion

An arcuate uterus is a common uterine malformation in which there is an indentation in the top portion of the uterus. It is considered a normal variation and remains asymptomatic in most cases of mild to moderate levels of an arcuate uterus.

However, in a severe arcuate uterus, there is the possibility of experiencing unpleasant symptoms and having frequent miscarriages.

So, if you have had recurrent miscarriages due to an arcuate uterus and wish to find a solution, you can consult the skilled fertility specialists at Birla Fertility and IVF. The clinic has an excellent rate of success and contains up-to-date testing facilities. Additionally, Birla Fertility and IVF have centres in metro cities and several states in India.

To find relief from problems occurring because of a severe arcuate uterus, drop by a close Birla Fertility and IVF centre or book an appointment with Dr. Prachi Benara.

FAQs:

Can I conceive naturally with an arcuate uterus?

Ans. Yes. If you have a mild to moderate arcuate uterus, your ability to conceive will not be affected, and you will be able to conceive naturally without facing any problems. On the other hand, in the case of a severe arcuate uterus, pregnancy is possible. But you run a high risk of suffering from a miscarriage, preterm labour, and c-section delivery.

Can I get pregnant with an arcuate uterus?

Ans. Yes, you can get pregnant with an arcuate uterus. Having an arcuate uterus does not adversely impact your ability to become pregnant. Though with a severe arcuate uterus, you are at a high risk of experiencing complications in the later stages of pregnancy.