Getting Pregnant With a Bicornuate Uterus 

Learning you have a bicornuate uterus can feel overwhelming. You may start asking big questions: Can I still have a baby? Will my pregnancy be safe? 

 With the proper management and care, many women with a bicornuate uterus go on to have healthy pregnancies. However, it’s essential to understand the condition, its potential impact on fertility, and the steps you can take to increase your chances of a successful pregnancy.  

 This guide will walk you through what a bicornuate uterus is, how it impacts conception and pregnancy, and how to get the right care. 

What is a Bicornuate Uterus? 

The typical shape of the uterus is like an upside-down pear, rounded at the top and narrow at the bottom. Dr. William Schoolcraft, Founder and Chief Medical Officer of CCRM Fertility, puts it more plainly, “A bicornate uterus means, obviously, ‘bi-cornate’—two corners.” It’s sometimes known as a “heart-shaped uterus.” 

 It’s a pretty rare condition and may not be discovered until pregnancy or fertility issues arise. In fact, it’s only estimated that about 1 in 200 women have a bicornuate uterus, and many don’t know until they experience complications like multiple miscarriages. 

Causes 

A bicornuate uterus forms during fetal development when the Müllerian ducts, which should fuse into one uterus, fail to join completely. Dr. Schoolcraft explains, “The uterus should look like a triangle, but some women, congenitally, when they're forming as an embryo, their uterus doesn't develop properly. Instead of a triangle, it sort of looks like Mickey Mouse ears.” 

 It’s a congenital uterine anomaly, meaning it’s present from birth and not caused by lifestyle, infection, or previous surgery. 

How Do You Know You Have a Heart-Shaped Uterus? 

You may never have any physical symptoms of the condition, and many women go years without knowing they have a bicornuate uterus. But in some cases, symptoms include: 

• Repeated miscarriages 
• Irregular vaginal bleeding 
• Abdominal discomfort 
• Painful periods 
• Painful intercourse 

 It usually takes an imaging test, like a 3D ultrasound, MRI, or hysterosalpingogram (an X-ray procedure used to visualize the uterus and fallopian tubes), to confirm the condition.  

Treatment Options 

While you can't reverse a congenital uterine anomaly, treatment can help you manage symptoms and improve your chances of carrying a pregnancy to term. 

Hormones 

Sometimes hormones, like hormonal birth control or progesterone, can support the uterine lining and help with fertility.  

Bicornuate Uterus Surgery 

In severe cases, a type of pregnancy, metroplasty, may be performed. The procedure reshapes the uterus to create a more typical cavity. However, surgery is generally only considered after multiple pregnancy losses or if the uterus is severely malformed. 

Assisted Reproductive Technology (ART) 

While ART, such as IVF (in vitro fertilization), can help women conceive, a bicornuate uterus still presents challenges for carrying the pregnancy to term. Embryo implantation is typically unaffected, but maintaining the pregnancy may require additional interventions or monitoring. 

Complications of a Bicornuate Uterus and Pregnancy 

Pregnancy is possible with a bicornuate uterus, but it does come with some risks. Dr. Schoolcraft notes, “This can increase the risk of miscarriage, the risk of preterm labor. It increases the chance of the baby being breech or bottom-down, where a C-section is required.” 

 Potential complications include: 

• Preterm labor: The baby may not have enough room to grow, leading to early delivery. 
• Malpresentation: The baby may not settle into a head-down position due to the uterine shape, increasing the need for a cesarean section. 
• Incompetent cervix: In some cases, the cervix may open too early.  
• Premature rupture of membranes (PROM): The uterus may stretch too far, causing the water to break early. 

 Despite these risks, many women carry their pregnancies to full term, especially with the right care team. 

Considerations for a Successful Pregnancy with a Bicornuate Uterus 

Dr. Schoolcraft emphasizes that women born with this condition should seek a specialist to improve their chances of a safe pregnancy: “Once they're pregnant, they should probably see a high-risk pregnancy specialist to monitor them carefully, to maximize their chance of going full term.” 

Progesterone Hormonal Therapy 

Progesterone may help prevent early contractions or miscarriage, especially in women with a history of pregnancy loss. Your OB/GYN might prescribe this in early pregnancy to support the uterine lining. 

Cervical Cerclage 

If your cervix is considered weak or begins to shorten too early, a cervical cerclage may be recommended. This surgical stitch keeps the cervix closed until it's time for delivery. 

Regular monitoring, ultrasounds, and visits with a maternal-fetal medicine specialist can significantly improve outcomes. Remember, a successful pregnancy with a bicornuate uterus is entirely possible and not uncommon. 

Choosing The Right Fertility Care 

Getting pregnant with a bicornuate uterus can feel like walking into the unknown, but you're not alone. With advances in fertility medicine and specialized care, many women with this condition go on to have healthy pregnancies and beautiful babies. 

What matters most is finding the right provider. Look for someone who has experience managing high-risk pregnancies and understands your unique situation. Using the Lodus Health online booking platform makes it easy to find the right provider for your needs. With just a few clicks, you can connect with a fertility expert who can guide you through your journey with care and compassion. 

If you’ve been diagnosed with a bicornuate uterus or are struggling to conceive, don’t wait. Use the Lodus Health platform to find a provider who can help you navigate your fertility journey with confidence.