What Is a Bicornuate Uterus and How Does It Affect Fertility?

What Is a Bicornuate Uterus

The uterus is a crucial organ in a woman’s reproductive system, and any abnormalities can significantly impact her ability to conceive and carry a pregnancy to term. One such condition is a bicornuate uterus, which affects approximately 1 in 200 women and can cause fertility issues.

A bicornuate uterus is a heart-shaped or two-horned uterus different from the typical pear-shaped one. Additionally, women with a bicornuate uterus may require specialized care during pregnancy.

If you or someone you know has a bicorn uterus, it’s essential to understand the causes, symptoms, diagnosis, and treatment options to ensure the best chances of a healthy pregnancy. So let’s dive in and explore everything you need to know about a bicornuate uterus and how it affects fertility.

Understanding Bicornuate Uterus

A bicornuate uterus, also known as a heart-shaped uterus, is a type of congenital uterine malformation where a woman’s uterus is divided into two sections by a septum or wall of tissue. 

This can cause issues during pregnancy, as the shape of the uterus may interfere with the baby’s growth and cause complications during delivery. The condition is most commonly diagnosed during prenatal ultrasound. 

It is essential to note that while this condition can have profound implications, it is not life-threatening, and it is possible to have a successful pregnancy and delivery.  However, women with a bicornuate uterus should be monitored more closely during pregnancy, and they may need to take certain precautions to ensure safe delivery.

Also readWhat is Bulky Uterus?

Bicornuate Uterus Symptoms

Women with the bicornuate uterus are typically unaware of their unique uterine shape unless they have undergone an ultrasound or other diagnostic imaging test. As it is a congenital condition, most people are born with it and do not experience any apparent symptoms associated with a bicorn uterus.

However, in some cases, you might experience the following:

  • Painful menstruation
  • Heavy bleeding (menorrhagia)
  • Pelvic pain & discomfort
  • Painful intercourse
  • Vaginal bleeding

It is essential to understand these symptoms do not solely signify the presence of a bicornuate uterus. It is always a good idea to speak with the doctor to diagnose the condition and choose a better treatment option. 


A bicornuate uterus is a congenital abnormality that a woman is born with. This condition arises when a fetus’s uterus fails to develop normally in the womb due to the incomplete fusion of specialized ducts, resulting in a division of the upper part or horns of the uterus.

However, the exact cause of this abnormal development is unknown. Still, in some cases, it is believed to be due to genetic factors, hormonal imbalances, or exposure to environmental toxins during embryonic development. Additionally, certain medical conditions such as polycystic ovary syndrome (PCOS) and endometriosis have been linked to an increased risk of bicornuate uterus.

Unfortunately, this condition is not preventable or reversible once it is present in an individual.

Does Bicornuate Uterus Affect Pregnancy?

While it was previously thought that a heart-shaped uterus might impact a woman’s fertility, recent studies have shown that even having a bicorn uterus does not decrease the likelihood of becoming pregnant.

However, older research has indicated that this anomaly may be more prevalent among women who experience infertility.

The bicornuate uterus may impact pregnancy outcomes, although the extent of the impact may vary. The condition can lead to a higher risk of complications during pregnancy, such as 

  • Miscarriage
  • Preterm delivery
  • Fetal malpresentation
  • Cesarean delivery
  • Low birth weight
  • Vaginal bleeding

Additionally, there may be a greater likelihood of fetal growth restriction and placenta previa, where the placenta partially or fully covers the cervix. However, many women with a bicornuate uterus have successful pregnancies and deliver healthy babies. 

It’s essential for women with this condition to receive prenatal care from a healthcare provider experienced in managing high-risk pregnancies. With close monitoring and appropriate management, most women with a bicornuate uterus can have a safe and healthy pregnancy.

Bicornuate Uterus Diagnosis

  • Physical examination and ultrasound: Diagnosing begins with a physical exam and ultrasound, typically revealing the distinctive shape. During an ultrasound, the technician will look for the uterus’s distinct “heart-shaped” shape.
  • MRI Scan:  An MRI can also detect a bicornuate uterus and may be used if the ultrasound is inconclusive.
  • Further tests, such as hysterosalpingography and hysteroscopy, can be used to evaluate the structure of the uterus and surrounding organs.

Although it can cause fertility issues, and it is often asymptomatic, and many women are unaware that they have the condition until they start trying to conceive.

It can worry expectant mothers, but it is essential to remember that it can be managed with proper care and monitoring throughout the pregnancy.


While this condition is not life-threatening, it can cause significant discomfort and fertility issues. Fortunately, there are several treatment options available for women with bicornuate uterus.

Hormone Therapy

One option is to use hormone therapy, which can help reduce the horns’ size and improve fertility.


Surgical correction may be recommended for women with severe malformations that affect fertility or lead to recurrent miscarriages.

Assisted reproductive technology (ART)

Women with bicornuate uterus may sometimes require assisted reproductive technologies such as in vitro fertilization (IVF) to conceive.


A cerclage is a procedure in which a stitch is placed around the cervix to help keep it closed during pregnancy. Women may require this procedure to prevent premature labor and miscarriage.

Progesterone therapy

Progesterone is a hormone that helps to support a healthy pregnancy. Women with bicornuate uterus may require progesterone therapy to reduce the risk of preterm delivery.

Precautions for bicornuate uterus pregnancy

If you are pregnant and have been diagnosed with a bicornuate uterus, then here are some precautions mentioned below you must follow to ensure a healthy pregnancy.

  • Take your medicines on time as prescribed by your doctor; this will ensure a healthy pregnancy
  • Take regular health checkups to monitor your health conditions and avoid any complications.
  • Consult your reports with your doctor as the risk of preterm labour is higher during bicornuate uterus.
  • Be prepared for a delivery plan in advance.
  • Consult with your doctor and know the position of your baby. Head-first is an ideal position.
  • Take a balanced and nutrition-rich diet. Also, stay hydrated to support a healthy pregnancy.
  •  Healthcare providers may recommend bed rest or activity restrictions, especially if there are signs of preterm labour.

The bicornuate uterus has many complications during pregnancy, but healthy delivery is always possible by taking extra precautions.

A Word From Crysta IVF

Diagnosing a bicorn uterus can understandably cause anxiety and uncertainty for women hoping to become pregnant. However, it’s essential to recognize that many people with this condition go on to have healthy pregnancies and deliver healthy babies. 

With the proper medical care and support from qualified healthcare providers experienced in managing high-risk pregnancies, women with a bicornuate uterus can safely carry their pregnancies to term.

At Crysta IVF, we understand the challenges of infertility and high-risk pregnancies. We have helped many couples achieve their dream of parenthood and are committed to providing compassionate, individualized care to all our patients.

Updated on 29-11-23

Ritish Sharma

Ritish Sharma is a professional healthcare writer who has a good understanding of medical research and trends. He has expertise in clearly communicating complex medical information in an easy-to-understand manner. His writing helps people make informed decisions about their health and take control of their well-being.