CONGENITAL STRUCTURAL ABNORMALITIES

Congenital structural abnormalities of the female reproductive tract are abnormalities in the structure of the reproductive organs that are inborn, meaning, they have existed at birth. These abnormalities can happen in the vagina, ovaries, uterus or cervix and can potentially cause infertility.

Symptoms

While some congenital abnormalities have no symptoms, in certain cases one or more of the following symptoms can be shown:

• Problems in urination
• Incomplete breast growth
• Menstrual problems / no mentruation (primary amenorrhoea)
• Recurrent premature labour or miscarriage
• Menstrual cramping or pain
• Pain during intercourse
• Difficulty conceiving

Causes

While the cause is unknown, growth and development may be affected by genetic imperfections, or by intake of certain medications during pregnancy. Some of these structural abnormalities can affect fertility and add to pregnancy difficulties.

Types

There are many congenital structural abnormalities of the female genital tract that can occur in the vagina, ovaries, uterus or cervix. These deformities include:

Congenital anomalies of the uterus

The following are some congenital structural abnormalities of the uterus.

Septate uterus

This is a common abnormality that happens when a band of muscle or tissue separates the uterus into two areas. This condition can cause premature labour and miscarriage.

Bicornuate uterus

This is a heart-shaped uterus with two horns. It could also increase the risk for premature labor and miscarriage.

Arcuate uterus

The uterus has a surface that has a slight indentation. This condition may not lead to pregnancy loss.

Unicornuate

This is a uterus that is only partially developed.

Didelphys

This is a condition where a woman has two uteruses. Each uterus has a cervix.

Congenital malformations of the vulva

The following are some congenital structural abnormalities of the vulva.

Labial hypoplasia

This is when either of the labia doesn’t grow normally. The labia function as fat cushions that protect from injury.

Labial hypertrophy

This is a condition when the labia are enlarged. This can lead to constant irritations, infections and pain during sex.

Congenital anomalies of the hymen

The following are some congenital structural abnormalities of the hymen.

Imperforate hymen

A hymen is a layer that encompasses or covers the opening of the vagina. The hymenal tissue is a round type of tissue, which has a gap inside the middle. When there is no opening in the hymen, a layer covers the region and is called an imperforate hymen. This leads to irregular menstrual cycles, no menstruation, or difficulty in urination. The treatment for this is surgery.

Microperforate hymen

A microperforate hymen is like an imperforate hymen, yet with a small gap inside. This gap makes it difficult for blood and bodily fluid to get through the hymenal opening. This also causes irregular menstrual cycles or difficulty in urination. Treatment is surgery.

Septate hymen

A septate hymen is a condition where the hymen has additional tissues in the center, causing two little vaginal openings rather than one. This may lead to pain and bleeding and is removed by surgery.

How is it diagnosed?

Your doctor will certainly recognise a structural abnormality of the reproductive tract by obtaining a medical history and doing a physical examination. Other tests include:

• Hysterosalpingogram (HSG)
• Ultrasound of the womb
• Magnetic resonance imaging (MRI)

Treatment options

Congenital uterine abnormalities are usually treated by surgery. The following procedures may be used:

Laparoscopy

This procedure uses a slender, lighted tube that will be inserted through a cut in your abdomen. This is a minimally-invasive procedure.

Hysteroscopy

This is also a minimally invasive procedure that can remove polyps, tumours or abnormalities by cautery.

Talk to us if you want to know more about congenital structural abnormalities that can affect your fertility.