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What is a unicornuate uterus?

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Posted on Sat, 7 Jun 2014
Question: Bulky uterus measuring 18cm×8.1×13.9cm. The largest 8.3x6.5.7.2 mid uterus. 4.0x3.1x3.5 cm fibroid lower uterus. 5.6 cm fibroid that extends into the endometrial canal.Right ovary not well visualized. Hyper echo structure with a complex cyst component measuring 4.8x4.3x4.8 in right Adnexa which may represent a partially necrotic fibroid or ovarian tissue. The left ovary unremarkable measuring 2.8x1.6x1.6cm no free fluid in culdasac. Just had hsg test done an found out i have a unicornuate uterus. I am 40yrs old as of dec 2013 an want to have a baby. Will I be able to get pregnant? How do I handle this situation? It's causing me a great deal of anxiety? What is a unicornuate uterus an should I have another test to confirm that?
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Answered by Dr. Mahesh Koregol (2 hours later)
Brief Answer:
Laparoscopy

Detailed Answer:
Hi

I read your query and I understand your concerns.

Following is my reply

1. Unicornuate uterus is a condition where in only one horn of uterus is well developed. Means your your uterus is half and hence it is difficult to carry pregnancy in such uterus.

2. Since there are large fibroids, they might compress uterus and appear like Unicornuate uterus. HSG cannot differentiate this.

3. Best solution for you is to undergo laparoscopy to remove fibroid and hysteroscopy to evaluate uterine cavity to confirm if there is Unicornuate uterus.

4. Laparoscopy can simultaneously remove the fibroids.

5. If you are not willing for laparoscopy then you have to undergo only hysteroscopy which will decide if Unicornuate uterus is present.

6. Since you are already 40 years old get ovarian reserve tested by a good IVF centre and see if you have enough eggs to conceive at this age even if you get uterus surgery done.

Let me know if you have any more questions.

Regards
Dr. Mahesh Koregol
IVF and infertility Specialist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Mahesh Koregol (1 hour later)
Will the hysteroscopy show where the fibroids are at an if the could be compressing the other horn. Cause I think in an ultrasound it talk about a fibroid on funds does Unicornate uterus have a fundus. Fsh test was 16 an lh test 5.7-7.3 amh test o.33 prolactin 6.8 estradiol was I think 27.7. Is there any hope to concieve.
doctor
Answered by Dr. Mahesh Koregol (1 hour later)
Brief Answer:
Hysteroscopy

Detailed Answer:
Hi

Hysteroscopy can show if there is fibroid compressing or endometrial compression. It can also check if cavity of uterus is adequate to carry pregnancy in case IVF done.

In your case only IVF with donor eggs seem to be best option as your ovarian reserve is very low based on hormonal reports you sent.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Mahesh Koregol (3 hours later)
Can i be given med to increase my hormone levels. I read testorials an alot of woman talk bout clomiphene what is that for?
doctor
Answered by Dr. Mahesh Koregol (19 minutes later)
Brief Answer:
Ovarian reserve

Detailed Answer:
Hi,

I understand how you feel. But unfortunately every woman is born with a particular number of eggs which get exhausted with each menstrual cycle in her life. This appears to be the scenario in your case. Your ovarian reserve seems to be exhausted with limited reserve.

There is no way this can be improved with any medicines.

Clomiphene citrate is a drug used in woman with normal ovarian reserve to stimulate and increase egg size. This cannot be used in you as ovarian reserve is less in your case.

Ovum donation seems to be the only solution.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Mahesh Koregol

Infertility Specialist

Practicing since :2000

Answered : 3813 Questions

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What is a unicornuate uterus?

Brief Answer: Laparoscopy Detailed Answer: Hi I read your query and I understand your concerns. Following is my reply 1. Unicornuate uterus is a condition where in only one horn of uterus is well developed. Means your your uterus is half and hence it is difficult to carry pregnancy in such uterus. 2. Since there are large fibroids, they might compress uterus and appear like Unicornuate uterus. HSG cannot differentiate this. 3. Best solution for you is to undergo laparoscopy to remove fibroid and hysteroscopy to evaluate uterine cavity to confirm if there is Unicornuate uterus. 4. Laparoscopy can simultaneously remove the fibroids. 5. If you are not willing for laparoscopy then you have to undergo only hysteroscopy which will decide if Unicornuate uterus is present. 6. Since you are already 40 years old get ovarian reserve tested by a good IVF centre and see if you have enough eggs to conceive at this age even if you get uterus surgery done. Let me know if you have any more questions. Regards Dr. Mahesh Koregol IVF and infertility Specialist