This is a 3D scan I did earlier today on a lovely patient of mine with what we call uterine didelphys, or double uterus.
This is an unusual but fascinating condition that is rare, occurring in 1 in 3000 women, as a result of embryological errors during reproductive organ development. It means that the patient has 2 cervices, and rarely a double vagina, though a vaginal septum is common. It makes it important to have smear tests that examine each cervix separately.
Each uterus has a single fallopian tube attached to the side, leading to a separate ovary. Many women may not have any symptoms, but others suffer from heavy bleeding or pain during intercourse. Associated problems could occur with the kidneys and skeletal system too, and it’s important to screen for these.
Importantly, having this condition does not necessarily reduce your fertility, though there are some potential associations.
It is perfectly normal to get pregnant naturally but other times, if fertility treatment is needed, the patient can go ahead with IUI or IVF but the doctor doing the embryo transfer has to be careful to identify the best cavity within which to place the embryo to give it the best chance of success.
When the patient is pregnant, the majority of patients can have uncomplicated vaginal deliveries. But the risk of preterm birth and malposition as well as miscarriage and intrauterine growth restriction is higher, and the patient needs to be monitored. It is rare for a woman to be pregnant in both uterine cavities, but very rarely, it can happen!
I have treated another patient before with this condition, I was her first doctor to diagnose it and I remember how upset she was to find out about it, as she naturally presumed she couldn’t conceive.
However, after one round of IVF, we got a beautiful embryo that we transferred, and she went on to become pregnant and carry to term, and have a normal vaginal birth! In fact she came to see me with her baby a few months ago.
