I have been diagnosed with uterus didelphys.  I have been told that if I can get pregnant, I can only get pregnant in the larger of the two horns, and that multiples were not an option.  I have been told that IVF would most likely be required.  What are the statistics with regard to success rates with this issue?  Any insight or personal experiences would be greatly appreciated!

johnaa - 08 September 2008 07:53 PM

I have been diagnosed with uterus didelphys.  I have been told that if I can get pregnant, I can only get pregnant in the larger of the two horns, and that multiples were not an option.  I have been told that IVF would most likely be required.  What are the statistics with regard to success rates with this issue?  Any insight or personal experiences would be greatly appreciated!

Dear Johnaa:
First, it is important to know that this is relatively rare and that uterine didelphys is often confused with a septate uterus, which is much more common. The management of these two conditions is quite different, so it is important to know for certain which type of uterus you have. 
Usually this diagnosis is first suspected on hsg, but hsg cannot distinguish between these two entities.  Sometimes you can tell on pelvic sonogram or saline hysterography, but often you need several tests to figure out which kind of uterus you have.  In my experience, the combination of HSG, pelvic sonogram, saline hysterography and pelvic MRI will diagnose the vast majority of cases.  In some instances, when the diagnosis is still not clear, surgery - laparoscopy and hysteroscopy will be required. 
If you have a septate uterus, minor surgery can be performed to normalize the uterine cavity.  If you have uterine didelphys, then surgery is not recommended and you will have to be followed very carefully during pregnancy.  Since the risk of preterm delivery is significantly increased w/ didelphys, multiples should be avoided.  Embryo implantation rates during IVF should not be affected by either of these conditions, although miscarriage rates are higher with an uncorrected septate uterus.
It is probably best to see a qualified reproductive endocrinologist regarding diagnosis and treatment for these conditions.
Hope this is helpful.
Best of luck,
Serena Chen, MD
http://www.sbivf.com
http://www.serenachen.yourmd.com

I, too, have UD, but had no problems getting pregnant.  I didn’t know it was UD until after my daughter was born and I had surgery to remove a fibroid which turned out to be my other uterus.  THe problems I had were bedrest, early labor (31 weeks) that was stopped, my daughter didn’t grow as expected (but turned out to be 6 lbs), and a planned csection at 37 weeks.  The only part I have separated is my uterus.  I understand some people have a separated cervix and sometimes vagina.

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I also have UD.  I am 23 weeks pregnant and had no problem getting pregnant.  I have the seperation in the uterus with 2 cervix and 2 vaginal openings.  The only difference so far is I am watched closer than a normal pregnancy.  I have an ultrasound every month to check on the growth of the baby and the competence of my cervix.  So far so good.  I haven’t had any complications as of yet.  We are planning to be ready for the baby around 6 weeks early instead of thinking we have until the due date.  Good luck!

About a year ago my doctor found out i had UD. I was reading more about it and a lot of women are saying they have pain when having sex. Yet i never do and ive also read that a lot of women got their wall removed. My doctor said theres no need to remove my wall. Is that true? Also, Ive read that women with UD cant use tampons because it would just run down the other side….that doesnt happen to me. Are these problems different for everyone or could it be my other “part” isnt working?

Dear dmarie:

About 75% of women with UD also present with a vaginal septum, an additional “wall” of vaginal tissue that usually extends longitudinally (up and down) within the vagina (below the uteri and cervices), effectively dividing the vagina into two parts. I think that the wall and surgery that you have heard about is referring to the accompanying vaginal septum. Women with vaginal septum may have difficulty with tampons if the tampon is only inserted into one side of the vagina due to the presence of the septum. The septum may also cause pain with intercourse. Both problems can be addressed by removal of the vaginal septum. If you are not having either problem, you may be among the fortunate 25% of women with UD without co-existing vaginal septum. Regardless, I would recommend that you ask your physician to clearly explain and diagram/draw your anatomy for you. This may require thorough exam and imaging tests including ultrasound, hysterosalpingogram/sonohysterogram and MRI. If you have no vaginal septum and two normal sized uterine cavities with good vaginal outflow (cavities and cervices lead to normal, unobstructed vagina), then you probably do not need surgery. About 15-20% of women with UD may also present with renal (kidney) anomaly, so please ask your MD about a renal ultrasound or other kidney imaging. Good luck!