Uterine Didelphys (Double Uterus): Causes, Symptoms, Diagnosis & Treatment
As a Gynecologist and Fertility Expert, I frequently encounter and manage complex cases, including patients presenting with Müllerian anomalies such as Uterine Didelphys, or ‘double uterus.’ Addressing patient concerns and providing expert management for these rare conditions is a core part of my specialized practice.
While it may sound alarming, this condition is often asymptomatic and does not typically interfere with fertility or pregnancy. Let me walk you through everything you need to know about uterine didelphys, from its causes to its treatment options.
What is Uterine Didelphys? (Definition)
Uterine didelphys, commonly called a double uterus, is a congenital (present since birth) condition. In this case, instead of a single pear-shaped uterine cavity, a woman develops two well-formed uterine horns.
This happens during fetal development when the Müllerian ducts, which normally fuse to form a single uterus, remain separate and form two distinct uterine cavities.
What causes Uterine Didelphys, and how does it develop embryologically?
Uterine didelphys is a rare condition that develops during the embryological stage.
Normally, the Müllerian ducts fuse during fetal growth to form a single, complete uterus. In uterine didelphys, these ducts fail to fuse, which leads to the presence of two separate uteri, each fully formed. This condition is purely developmental, not genetic, and there are no known hereditary causes.
What are the common symptoms of Uterine Didelphys?
Most women with uterine didelphys experience no specific symptoms.
- Since it is a non-obstructive Müllerian anomaly, it does not cause significant pain, discomfort, or menstrual issues in most cases.
- Some rare cases may present with heavy menstrual bleeding, but this is uncommon.
Get Expert Guidance from Dr. Jay Mehta—Müllerian Anomaly Specialist in India
How is Uterine Didelphys diagnosed?
The best ways to diagnose uterine didelphys are
- 3D Transvaginal Ultrasound: This is often the first step in identifying uterine anomalies.
- MRI of the Pelvis: This provides a detailed view of the uterine structure and confirms the presence of two separate uterine cavities
Uterine Didelphys MRI/Ultrasound Findings
On MRI, uterine didelphys is seen as two completely separate uterine cavities, each well-defined and independent.
How are Uterine Didelphys and renal anomalies related?
In some women, uterine didelphys is also associated with renal anomalies, such as having only one kidney (unilateral renal agenesis)
This association is part of a rare condition called OHVIRA syndrome (Obstructed Hemivagina and Ipsilateral Renal Anomaly).
How does Uterine Didelphys affect pregnancy outcomes?
One of the most common concerns I hear from patients is whether uterine didelphys affects pregnancy. The good news is that this condition does not typically impact fertility or pregnancy outcomes. Whichever uterus the fetus implants in will function normally, and most women with uterine didelphys go on to have healthy pregnancies.
Fertility Complications in Uterine Didelphys
Since both uteri are completely formed:
- No major fertility complications are expected.
- Women with uterine didelphys usually conceive naturally.
Is Treatment Necessary for Uterine Didelphys?
In most cases, no treatment is required for a double uterus or a uterine didelphys. . Since both uteri are fully formed and functional, there are no fertility or pregnancy-related complications that necessitate intervention.
Uterine Didelphys vs. Bicornuate Uterus
It’s important to understand how uterine didelphys is different from similar conditions:
| Feature | Uterine Didelphys | Bicornuate Uterus |
|---|---|---|
| Number of Uterine Cavities | Two separate uteri, fully formed | One uterus with two connected horns |
| Cervixes | Two distinct cervixes | Usually one cervix |
| Uterine Cavities | No communication between cavities | Cavities are partially connected |
What syndromes are commonly associated with Uterine Didelphys?
Apart from having a few rare cases of renal anomalies, especially in association with uterine didelphys, along with unilateral renal anomalies, also called OHVIRA syndrome.
What are the surgical options for treating Uterine Didelphys?
In the majority of situations, when there is a double uterus or a uterine didelphys, any type of surgical option is not recommended. This is because embryologically, both of the uteri are complete, and they do not require any form of unification.
Prognosis & Long-Term Outcomes
Women with uterine didelphys can expect a normal reproductive life. There are no long-term complications.
Genetic Factors
There are no genetic factors that are known to contribute to the formation of a double uterus
What are the treatment options for Uterine Didelphys with a double vagina?
Many times, the presence of a double uterus or a didelphys uterus is also associated with the presence of a double vagina, and the genuine majority of the patients do not even come to know about the same till they are actually trying for a conception.
Having a double vagina does not really make any difference as far as having sexual activity is concerned. No specific management is recommended for having a double vagina, unless it creates a problem in having intercourse.
What menstrual disorders are associated with Uterine Didelphys?
In a normal situation, a patient needs to understand that the double uterus does not cause any menstrual complaints for the patient. Do it in some rare situations. It may be associated with heavy menstrual bleeding in patients.
Uterine Didelphys vs. Bicornuate Uterus vs. Septate Uterus
| Feature | Uterine Didelphys (Double Uterus) | Bicornuate Uterus | Septate Uterus |
|---|---|---|---|
| Definition | Two completely separate uteri (double uterus) | Single uterus with two cavities partially joined | Single uterus with a fibrous/muscular septum dividing the cavity |
| Embryology | Complete failure of Müllerian duct fusion | Partial failure of fusion | Failure of resorption of the central uterine septum |
| Cavities | Two completely separate cavities | Two cavities connected at the lower part | One cavity, divided by a septum |
| Cervix | Usually two cervices present | One cervix | One cervix |
| Symptoms | Usually asymptomatic; sometimes heavy bleeding | Rarely symptoms cause miscarriage | May cause infertility, miscarriage, heavy periods |
| Diagnosis | 3D Ultrasound/MRI | 3D Ultrasound/MRI, | 3D Ultrasound / MRI / Hysteroscopy |
| Fertility Impact | Usually normal fertility | Fertility may be slightly reduced | Higher risk of infertility and miscarriage |
| Pregnancy Outcomes | A normalis pregnacy possible in either uterus | May increase miscarriage risk | Repeated miscarriages are common if untreated |
| Treatment | No treatment needed | Surgery not usually required | Hysteroscopic septum resection if symptomatic |
| Prognosis | Excellent, no long-term issues | Generally good | Very good after surgical correction |
Key Points
Uterine didelphys (double uterus) may sound worrying, but in reality, it rarely causes any problems with fertility, pregnancy, or long-term health. Most women live normal, healthy reproductive lives without even realizing they have it.
If you have been diagnosed with uterine didelphys, don’t panic. It’s important to get the correct evaluation with a 3D ultrasound or MRI and consult a fertility expert who can guide you on your unique case.
At Shree IVF Clinic, Mumbai, I specialize in evaluating rare uterine anomalies like uterine didelphys. If you are concerned about your fertility or pregnancy outcomes, I would be happy to guide you with personalized care.
👉 Book your consultation with Dr. Jay Mehta at Shree IVF Clinic today and get clarity on your fertility journey.
FAQs About Uterine Didelphys
– Is uterine didelphys dangerous?
No, it is not dangerous. It usually does not affect health, fertility, or pregnancy.
– Can I get pregnant with uterine didelphys?
Yes, most women with uterine didelphys conceive naturally and have successful pregnancies with the right care.
– Does uterine didelphys require surgery?
No. Surgery is not needed as both uteri are fully functional. Surgery is only needed in rare cases, like if there are repeated miscarriages or pain during intercourse due to a vaginal septum
– Is uterine didelphys hereditary?
No, there are no known genetic factors associated with uterine didelphys.
– Will my periods be affected?
Usually, no. Some women may have heavy or painful periods, which can be managed with medical care.
– Can uterine didelphys cause menstrual problems?
In most cases, uterine didelphys do not cause menstrual issues. However, some women may experience heavy bleeding or painful periods.
– Is uterine didelphys associated with other conditions?
Yes, it can be associated with renal anomalies, such as a single kidney, and in rare cases, OHVIRA syndrome.
– What is the difference between uterine didelphys and bicornuate uterus?
In didelphys, there are two separate uteri. In the bicornuate uterus, the cavities are connected.
Dr Jay Mehta
Scientific Director & IVF Specialist with 10+ years of experience
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