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    fertility basics

    Bicornuate Uterus - Symptoms, Causes, and Treatment of Bicornuate Uterus

    • 4.6   (6 Votes)
    Medically Reviewed by Dr. Deepika Tiwari - MS, MBBS on 25 Apr 2018 - Written by Dr. Sheetal Pandey Tejwani - Fellowship, MS, MBBS - Grammatically Approved by Dr. Kavita Jaggi Agrawal - MS, MBBS

    Bicornuate uterus symptoms are repeated miscarriages, irregular bleeding, pain during intercourse, and premature labor. Bicornuate uterus causes are mainly congenital in nature. Bicornuate uterus treatment includes undergoing surgical procedures to have a successful pregnancy.

    Bicornuate Uterus is a congenital uterine anomaly found in a number of women across the world where the uterus is heart shaped. The normal uterus has one cavity but bircornuate uterus has two cavities. The uterus appears like a two-horn structure, which divides the uterus in two parts. This is a congenital uterine anomaly that can meddle with a woman’s reproductive capabilities thereby making it difficult for her to conceive.  

    The shape of a woman’s uterus remains a crucial aspect, as it is the place where the baby is positioned during pregnancy. Although the anomalies related to the uterus are not very common yet still bicornuate uterus is the most common condition of all among the defects found in the women who suffer from the abnormal shape, size, and structure of uterus.

    This condition can be surgically corrected if required and it has been seen in studies that around 90% of the women were able to complete pregnancy term after removing the septum. It has also been observed that women with bicornuate uterus show a success rate of 60% but a great risk of cervical incompetence is always there. Spontaneous miscarriages, preterm delivery and incompetent cervix are a major indicator of the condition.

    Bicornuate Uterus Effects on Pregnancy

    It is seen that the “heart shape” of the uterus doesn’t have an immediate impact on pregnancy that is it doesn’t really interferes with the fertility of a woman or conceiving a baby but its effects become visible only in form of miscarriages and premature labor. Due to lesser space inside the uterine cavity one can experience preterm labor, miscarriages in second trimester and slow growth of baby. There have been researches though, that have shown that it’s more prominent in infertile women. It is made clear by various researchers that the main cause of the complications during pregnancy is due to irregular uterine contractions or reduced capacity of the deformed uterus. Also, the chances of pregnancy in women due to uterus anomalies could fall from 37.6 percent to 1.8 percent.

    Bicornuate Uterus Effects on Pregnancy

    Moreover, it is a greater possibility that a mother with this kind of a defect may give birth to a baby with congenital defects as compared to a mother who does not have it and the chances are as high as four times as stated in a study. A pregnancy with a bicornuate uterus is considered as high-risk and is subjected to close monitoring by a doctor to constantly determine the position of the baby inside the uterus that could be done with the help of frequent ultrasounds. It can be seen that the baby may come to breech position indicating the downward position of the feet hence more testing is required at various stages and the likeliness of cesarean at the time of the birth is more.

    This article enhances your information on the causes, symptoms, diagnosis, and treatment of Bicornuate Uterus. But, firstly let’s have a look on the different types of uterus and difference between them.

    Differences between Bicornuate Uterus and Septate Uterus

    Sometimes, the uterus has a single cavity but a wall known as septum divides it partially or completely. This type of uterus is known as septate uterus, which is different from bicornuate uterus. A true bicornuate uterus is the one where two uterine horns actually migrate down but both of the arms or horns don’t completely fuse to make a normal uterus. Now, if we talk of septate uterus, itis an abnormality where the uterine horns fuse completely, but the intervening septum is not completely absorbed. The uterus then appears as two horns internally, but externally looks to be unified. Sometimes, just after seeing an ultrasound report doctors cannot determine whether the uterus is bicornuate or septate.

    septate uterus

    In such cases, a noninvasive procedure called a pelvic MRI can distinguish these two circumstances and other uterine congenital abnormalities. But, a reproductive endocrinologist best knows whether the uterine abnormality is bicornuate or septate one.

    Symptoms of Bicornuate Uterus

    Check here the symptoms and the reasons causing Bicornuate Uterus and get aware of the facts about bicornuate uterus. The condition in most of the women goes undetected due to the fact that it doesn’t show any significant symptom until you have undergone an ultrasound or a specific test that may help to bring out the condition. Whereas there are women who report specific symptoms such as:

    • Repeated miscarriages
    • Irregular bleeding
    • Pain during intercourse
    • Painful periods
    • Abdominal discomfort
    • Premature labor
    • Retained or trapped placenta

    Causes of Bicornuate Uterus

    Below is the described information about the causes of bicornuate uterus that will help you get aware of right and precise facts. The condition is congenital and is found right from the time of the birth of a woman. It simply means that the uterus of a girl was not formed properly in the womb. The partial fusion of the special ducts leads to the separation of the upper parts of the uterus and they stick out in order to give a heart-shape to the uterus. This condition is entirely congenital and there are no means to prevent it.

    Bicornuate uterus

    Diagnosis of Bicornuate Uterus

    Before going for bicornuate uterus treatment you definitely need to go and get diagnosis done for the problem. There are different tests that may be carried out to determine the presence of a bicornuate uterus like:

    • Magnetic resonance imaging (MRI)
    • Ultrasound
    • Pelvic exam
    • Hysteroscopy
    • Laparoscopy

    The condition is usually noticed at the time of an ultrasound imaging during pregnancy or just to diagnose the cause of certain unwanted symptoms. There are many women that remain unaware of the condition for a long time of their lives.

    Treatment of Bicornuate Uterus

    Although a majority of the women do not need a surgical method for the correction. But some women find it really hard to get pregnant and may need surgical intervention. A surgical method named Laparoscopic Strassman’s Metroplasty is carried out in women that show a history of spontaneous miscarriages.  Notably, it was observed in a research that a majority of women that underwent a surgical procedure for the correction of the uterus ended up having successful pregnancies and child birth.

    The fact that the condition doesn’t have an apparent effect on the chances of becoming pregnant, the means to correct it through surgery is a controversial subject. It’s important that you undergo a proper examination of your reproductive system before planning a pregnancy to identify any such issues. It may not directly impact your chances of getting pregnant yet may result in miscarriage during the later stages of pregnancy or even early birth. It’s however, quite possible to have a successful pregnancy and delivery by acquiring suitable medical aid and careful treatment procedure.

    A separate uterus can be easily repaired with the medical-surgical process known as hysteroscopy through septum resection.  A true bicornuate uterus is uncomplicated to move toward with a major surgical treatment known as Strassmann method. Suffering from a bicornuate uterus is most likely to affect your fertility. But for some instance, it could become the problem and would lead to miscarriage and early birth. But still, after this, there are no worries as you may still be able to have a successful pregnancy and delivery.

    But why take a risk? It is important to enclose your history with a good medical team that will monitor your pregnancy  carefully from time to time. Seek our help and we are there to help you avail the best information and guide from the best consultant.

    Be sure about getting the right time treatment for the bicornuate uterus and get expert’s advice also. Just connect us at +91-7899912611 for any fertility related assistance.

    Dr. Sheetal Pandey Tejwani

    Written by

    Fellowship, MS, MBBS, DNB
    Laparoscopic Surgeon, Gynecologic Surgeon
    Dr. Sheetal Pandey Tejwani is an Infertility Specialist, Gynecologic Surgeon and Obstetrician, located in Mumbai and having an experience of almost a decade. Her alma mater is B J MEDICAL COLLEGE in Pune from where she completed her MBBS and MS in Obstetrics and Gynaecology in 2007 and 2009, respectively. In the following year, she pursued her DNB in Obstetrics and Gynecology. She received her Post Doctoral Fellowship in Reproductive Medicine from Krishna IVF Vizag and Nadkarni IVF Centre, Surat in 2013. She is the member of 3 different associations i.e. Indian Society of Assisted Reproduction (ISAR), Indian Medical Association (IMA), and Association of Medical Consultants. Her area of expertise includes Tubectomy/Tubal Ligation, Hysterectomy (Abdominal/Vaginal), Intrauterine Insemination (IUI), Caesarean Section and In-Vitro Fertilization (IVF). She is a consultant in Veda Fertility And Urology Care, Mira Road and is a visiting consultant in Wockhardt Hospital, Mira Road, Mumbai. You can get the contact details of Dr. Sheetal Pandey Tejwani at


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    Shradhaa Rao

    I had repeated miscarriages due to the bicornuate uterus. So, my husband and I opt for surrogacy to have a child as we didn't want to have any surgery.

    Oct. 12, 2018, 2:29 p.m. 4.5


    Chetan Rama

    I really can't understand the difference between Bicornuate Uterus and Septate Uterus? Please explain if anybody could!

    Aug. 25, 2018, 9:25 p.m. 4.5


    Radhika Singh

    I have painful cycles and the intimacy is painful too, does that mean I have a bicornuate uterus?

    Aug. 23, 2018, 3:49 p.m. 5.0


    Conor Rigby

    My wife has a bicornuate uterus but she never had any problem with a pregnancy and delivery.

    June 11, 2018, 4:12 p.m. 4.5


    Shammy Shell

    I try learning something new every day and it was completely rare and informative. Thanks for sharing the article.

    May 19, 2018, 2:10 p.m. 4.5


    Elzanne Pretorius

    I have a bicornuate uterus, diagnosed when I was 19 with a pelvic exam. I'm 27 now and have 2 babies both carried till full term. Also, I had natural birth both the times with no complications.

    May 17, 2018, 10:02 a.m. 4.5

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