For women living with a heart-shaped uterus, also known as bicornuate uterus, trying to conceive and then going on to labor and delivery, has in some cases been problematic. This malformation of the uterus happens during development as an embryo. For some women, a heart-shaped uterus may be a contributing factor to fertility problems.
When a female embryo is forming, somehow the fusion process of the mellurian ducts does not form as it should, thus the top part of the uterus forms in two separate sections with “horns” on each top section, while the lower part remains normal as one part. This is where the heart-shaped and bicornuate names come from. In women with this condition the uterus forms the shape of a heart rather than and upside down pear shape. This malformation can be in varying degrees. For some there will be a uterus that appears to be almost split into two different uterine cavities, while others only have a slight heart-shape appearance.
I was quite surprised to find out that only about 1% of all women in the United States have a heart-shaped uterus. I was surprised because honestly we get quite a few women writing in that have this condition. I also have personally know many women who have a heart-shaped uterus. Of all these women none that I know personally has ever had trouble conceiving, but all of them have had labor and/or delivery problems. We do get a lot of questions from women wondering if having a heart-shaped uterus is contributing or causing their fertility struggles. The answer cannot be a simple yes or no, and that is because of the varying degrees of this condition.
Is My Heart-shaped Uterus Causing My Difficulty in Conceiving?
If the only fertility issue that you know of is your heart-shaped uterus, then you may want to ask your doctor about the exact shape of your uterus to see severity of the malformation. Recent studies cannot confirm that a heart-shaped uterus alone causes infertility. A uterus that has a top that is split into two different cavities is more likely to cause issues during pregnancy, labor and delivery. If you have a heart-shaped uterus and continue to struggle to get pregnant, there is probably some other fertility issue going on that is causing your difficulties. It would be best to talk to your doctor about this.
Women with a heart-shaped uterus are more likely to have difficulties after they become pregnant.
- Risk for recurrent miscarriage goes up in women with a heart-shaped uterus. The reproductive potential for women with bicornuate uterus is measured by the live birth rate, which has been estimated at 63% for women with this condition.
- Women with a bicornuate uterus have a 15-25% chance of preterm delivery. This can be dangerous for the baby’s survival, especially if the mother goes into labor before the baby is fully developed.
- In a partial bicornuate uterus, 40-50% of all babies present as breech (feet first) during labor and delivery. Women with a complete bicornuate uterus had 0% breech presentation. Breech presentation increases potential complications for labor and delivery for the mother and child. Babies presenting breech are considered slightly higher risk and may end up in cesarean section.
- Higher risk of cervical incompetence. If cervical incompetence is present, a cervical cerclage may be necessary. A cervical cerclage is where the cervix is stitched closed at a certain point in the pregnancy, usually during the second trimester. The cerclage is then taken out at the end of pregnancy in preparation for labor and birth.
What Can I Do Naturally to Improve My Chances of Carrying to Term?
With physical abnormalities of the uterus, the most important thing you can do would be to keep the uterus as healthy as possible by maintaining it’s strength, circulation and position. This also includes addressing any other fertility issue you may have such as uterine fibroids, hormonal imbalance, endometriosis, ect. Our Improving Uterine Health for Fertility, Conception and Implantation article is a great guide to maintaining uterine health overall. You will want to keep your uterus in top shape if you are already facing pregnancy, labor and birth with a heart-shaped uterus. This will give you the best chances for a healthy pregnancy, labor, delivery and baby possible! It is important to think ahead before trying to conceive. If you have a heart-shaped uterus you will want to prepare in advance of conception; think of ways to increase your uterine health.
The best ways to maintain proper uterine function and health are:
Diet and Exercise: Eating a wholefood nutrient dense diet. Walking and Fertility Yoga are two of the best ways to maintain uterine health and position.
Self Fertility Massage and Maya Abdominal Massage: This type of massage helps to maintain proper alignment of the uterus, increase and maintain healthy circulation, helps to promote a healthy menstrual cycle, maintain strength of uterine muscles, and support proper hormonal balance.
Herbs: There are many herbs specific as uterine tonics that help the uterus to slightly contract to help maintain muscle tone of the uterus. Herbs that are uterine tonics that have been shown safe for daily use prior to ovulation are; Raspberry leaf and Evening Primrose Oil.
2) Reproductive Performance of Women with Uterine Anomalies: An evaluation of 182 cases
1982, Vol. 61, No. 2 , Pages 157-162