Müllerian Duct Anomalies

Müllerian Duct Anomalies (MDA)

Early in the first trimester of pregnancy, a female’s reproductive system begins to form. A pair of Müllerian ducts develop in the reproductive tract, a region that includes the fallopian tubes, uterus, cervix and upper vagina.

Sometimes, though, something goes wrong in this early stage of development, leading to a wide variety of malformations known as Müllerian duct anomalies. These are thought to affect about 4% of women.

What are Müllerian anomalies?

Müllerian anomalies can affect the shape and structure of the vagina, cervix, uterus and fallopian tubes, potentially leading to fertility difficulties.

The most common types of Müllerian anomalies are those affecting the uterus and cervix. These include:

  • Müllerian agenesis – the absence of a uterus.
  • Unicornuate uterus – only half the uterus forms and is shaped like a banana.
  • Didelphys uterus – a double uterus shaped like two bananas.
  • Bicornuate uterus – a heart-shaped uterus with an indentation at the top.
  • Septate uterus – a changed shape inside the uterus.
  • Cervical agenesis – a missing cervix.
  • Cervical duplication – two cervixes.
  • Cervical hypoplasia – an abnormally small.
  • Vaginal septum – when the vagina is divided in two (a transverse septum can block menstrual flow).
  • Obstructed uterine horn – only one part of the uterus forms without attachment to the vagina or cervix.

Signs and symptoms

At birth and throughout childhood, there’s rarely any clue about the existence of Müllerian duct anomalies.

The first clues may come in adolescence or young adulthood. Signs and symptoms include:

  • Amenorrhea – absence of periods
  • Pelvic pain
  • Difficulties using tampons or having sex.

Becoming a parent may also prove more complicated than expected due to:

  • Infertility
  • Recurrent miscarriage
  • Premature birth.

How are Müllerian anomalies diagnosed?

Müllerian duct anomalies are diagnosed through imaging tests, such as:

  • Pelvic ultrasound
  • Magnetic resonance imaging (MRI)
  • A hysterosalpingogram (X-ray) or saline sonogram (ultrasound) is where fluid is injected into your uterus

Your gynaecologist may also perform certain procedures to look around your pelvic organs (laparoscopy) or inside your uterus (hysteroscopy).

Often used in combination, these tests and procedures can tell us about the presence and type of a Müllerian duct anomaly. From there, we can advise you on how it may affect your life and recommend treatment.

Treatment options

Not all Müllerian duct anomalies require treatment. If the condition does not really affect your life or fertility, then treatment may not be necessary.

In many cases, though, gynaecological surgery is required to correct a Müllerian duct anomaly. Surgery aims to:

  • Restore normal structure (where possible)
  • Reduce discomfort during sex or menstruation
  • Improve fertility
  • Reduce the risk of pregnancy difficulties like miscarriage, premature delivery or breech birth.

How can Dr Budden help?

Dr Aaron Budden is the only certified advanced laparoscopic gynaecological surgeon between Newcastle and the Gold Coast. He provides obstetric and gynaecological care in Coffs Harbour and Port Macquarie.

If you have any concerns about your gynaecological health, please ask your GP for a referral or contact us.

 

Disclaimer

All information is general and is not intended to be a substitute for professional medical advice.

References