Patient Factsheet teaser

Abnormalities of the Female Reproductive Tract (Müllerian Anomalies)

Revised 2023


fig1-abnormalities.webp


What are the Müllerian ducts?

Like other organs in the body, the uterus and fallopian tubes take shape while a fetus is still inside the uterus. These reproductive organs develop from two ducts known as the Müllerian ducts.

During normal development, these ducts come together, fuse, and the intervening tissue wall disappears. When this happens, a single uterus with an open cavity and two fallopian tubes are formed. Sometimes, however, the uterus and fallopian tubes may not form as they should. These malformations are called Müllerian anomalies. Müllerian anomalies may make it difficult or impossible to become pregnant.


What types of müllerian anomalies are there?

There are an indefinite number of anomalies in development, but the most common types are:

  • Müllerian agenesis, which is a failure to form the uterus and fallopian tubes
  • Disorders of fusion, which occur when the müllerian ducts fail to come together correctly

Sometimes, kidney problems may be present in women with müllerian abnormalities, mainly because the kidneys develop next to the müllerian system.

What is Müllerian agenesis?

Müllerian agenesis (sometimes called Mayer-Rokitansky-Kuster Hauser [MRKH] syndrome) happens when the uterus, cervix (opening of the uterus), and upper vagina don’t develop correctly or at all. Instead, there is a small vaginal opening or dimple.

An individual with MRKH has normal ovaries and will have normal development of breasts, clitoris (part of the vulva), and vulva (external genitalia). The cause is often unknown, but it occurs early in development.

An individual with MRKH may not become aware until they are older. The main symptoms are the absence of periods and/or pain when attempting sexual intercourse. An individual with MRKH can sometimes have surgery or use dilators to enlarge the vagina. Also, since an individual with MRKH has ovaries that produce eggs, having biologically related children is possible, but will require use of vitro fertilization (IVF) and a gestational carrier or uterine transplant.

What types of Müllerian duct fusion disorders are there?

Some simple examples pictured below include:

  • A complete duplication of the uterus. In this situation, there are two uteri, cervices, and vaginas.
  • A bicornuate uterus, in which two uteri share a single cervix and vagina.
  • A septate uterus. In this situation, there is typically a fibrous band of tissue going through the uterus.
  • An arcuate uterus, which means there is a mild indentation of the inner top wall of the uterus.
fig2-abnormalities.webp

Can Müllerian anomalies be corrected with surgery?

It is important to note there are many variations of mullerian anomalies, and not all require surgical correction. You should speak with your doctor about what is right for your situation. For instance, some individuals may have painful periods relating to their anatomical difference, which may improve with surgery.

How do Müllerian anomalies impact an individual’s ability to get pregnant?

It depends on the anomaly. While those with Mullerian agenesis will require a gestational carrier or uterine transplant to carry a pregnancy, many individuals with fusion disorders can become pregnant and carry a pregnancy without complications. Due to the shape of the uterus, however, some individuals with fusion disorders may be at higher risk for pregnancy complications, like miscarriages, preterm births, and breech positions of the baby. Difficulties with pregnancy depend on the specific fusion disorder present. The best way to diagnose a fusion disorder is with 3D ultrasound, magnetic resonance imaging (MRI), or a surgical procedure.

Fact Sheets/Booklets

View more fact sheets and booklets written by the ASRM Patient Education Committee.
Patient Factsheet teaser

Menopausal Transition (Perimenopause): What Is It?

The menopausal transition (perimenopause) is the period that links a woman’s reproductive (childbearing) years and menopause.
Patient Factsheet teaser

Osteoporosis

Osteoporosis and osteopenia are conditions of having low bone mass (density).
Patient Factsheet teaser

Hyperprolactinemia (High Prolactin Levels)

Prolactin is a hormone produced by your pituitary gland which sits at the bottom of the brain.
Patient Factsheet teaser

Stress and infertility

It is not clear how exactly stress impacts fertility.

Resources For You

The American Society for Reproductive Medicine (ASRM) is committed to providing patients with the highest quality information about reproductive care.

Female Fertility

Podcast Icon

SART Fertility Experts - Fertility Myths and Realities for Black Women

Black women are more likely to experience infertility and less likely to seek and receive timely treatment. Listen to the Episode
Podcast Icon

SART Fertility Experts - Wellness and Fertility: Diet, Sleep and Exercise

Drs. Timothy Hickman and Rashmi Kudesia discuss the links between lifestyle and fertility. Listen to the Episode
Podcast Icon

SART Fertility Experts - Preconception Counseling

This podcast episode covers the topic of preconception counseling.  Listen to the Episode
Patient Ed Icon

Female Fertility Journey

If you've been trying to get pregnant for more than a year, you may have infertility. Infertility is a disease of the reproductive system that impairs one of the body's most basic functions: the conception of children.

View the Patient Journey
Patient Ed Icon

Stress and infertility

It is not clear how exactly stress impacts fertility. Read the Fact Sheet
Patient Ed Icon

Optimizing Natural Fertility

Before attempting pregnancy, a woman should make sure she is healthy enough for pregnancy by adopting a healthier lifestyle and taking prenatal vitamins. If she has a medical or genetic condition or risk of one, she should seek advice from a medical professional before conceiving (becoming pregnant) View the fact sheet
Patient Ed Icon

Am I Ovulating?

Ovulation is the release of an egg from a woman’s ovaries and is essential for getting pregnant. View the Fact Sheet
Patient Ed Icon

Abnormalities of the Female Reproductive Tract (Müllerian Anomalies)

Sometimes the uterus and fallopian tubes may not form like they should. These malformations are called müllerian anomalies or defects. Müllerian anomalies may make it difficult or impossible to become pregnant. View the Fact Sheet
Patient Ed Icon

Conditions Treated with Surgery on the Fallopian Tubes and Ovaries

Surgery can be used to treat problems with the ovaries or fallopian tubes, such as cysts, endometriosis, or infections. View the Fact Sheet
Patient Ed Icon

Diagnostic Testing for Infertility

An evaluation of a woman for infertility is appropriate for women who have not become pregnant after having 12 months of regular, unprotected intercourse. View the Fact Sheet
Patient Ed Icon

Dilation and Curettage (D&C)

“Dilation and curettage” (D&C) is a short surgical procedure that removes tissue from your uterus (womb). You may need this procedure if you have unexplained or abnormal bleeding or if you have delivered a baby and placental tissue remains in your womb. View the Fact Sheet
Patient Ed Icon

Evaluation of the Uterus

If you haven’t been able to get pregnant after trying for 6 months, some tests can be done to help find the reason. Your doctor may test your hormone levels, your partner’s sperm, and your reproductive organs (ovaries, fallopian tubes, and uterus [womb]). View the Fact Sheet
Patient Ed Icon

Female Cancers, Cryopreservation, and Fertility

Yes! New technology lets your doctor remove and freeze eggs, fertilized eggs (embryos), or ovarian tissue before treating your cancer. This way, you may be able to have children after your treatment. View the Fact Sheet
Patient Ed Icon

Fertility Drugs And The Risk of Multiple Births

Infertility treatments that cause multiple eggs to develop make it more likely that you will become pregnant with twins, triplets, or more. This is called multiple gestation. View the Fact Sheet
Patient Ed Icon

Ovulation Detection

Ovulation, the release of an egg from its follicle in one of a woman’s two ovaries, is one of the most important factors in conceiving a child. View the fact sheet
Patient Ed Icon

Weight and fertility

One of the easiest ways to determine if you are underweight or overweight is to calculate your body mass index (BMI). View the fact sheet
Patient Ed Icon

Hypothyroidism and pregnancy: what should I know?

Hypothyroidism (underactive thyroid) is when the thyroid gland produces less  thyroid hormone than it should. View the Fact Sheet
Podcast Icon

SART Fertility Experts - Endometriosis

Endometriosis is a condition that can affect many facets of a person’s life, from pelvic pain to struggles with infertility.   Listen to the Episode
Podcast Icon

SART Fertility Experts - IVF: Cycles of Hope and Heartbreak

Does stress cause infertility or is it the other way round?  Listen to the Episode
Patient Ed Icon

What is Recurrent Pregnancy Loss (RPL)?

This is a condition when a woman has 2 or more clinical pregnancy losses (miscarriages) before the pregnancies reach 20 weeks. View the fact sheet
Podcast Icon

SART Fertility Experts - Fibroids and Fertility

Fibroids and their impact on fertility are discussed in this episode featuring Dr. Elizabeth Stewart, interviewed by host Dr. Brooke Rossi.  Listen to the Episode
Patient Ed Icon

Infertility: an Overview (booklet)

Infertility is typically defined as the inability to achieve pregnancy after one year of unprotected intercourse. View the booklet
Videos Icon

Infertility

Infertility is the result of a disease (an interruption, cessation, or disorder of body functions, systems, or organs) of the male or female reproductive tract which prevents the conception of a child or the ability to carry a pregnancy to delivery.  Watch Video
Videos Icon

Basic Infertility Evaluation

Dr. Roger Lobo of the American Society for Reproductive Medicine discusses the various methods to evaluate infertility. Watch Video
Videos Icon

Fibroid Tumors

An educational video that answers patient questions about the causes, symptoms, diagnosis and management of uterine fibroids. Watch Video
Videos Icon

Infertility Treatments

Dr. Roger Lobo of the American Society for Reproductive Medicine discusses the various treatments for infertility. Watch Video
Videos Icon

Understanding Fertility

In this video series, Dr. Roger Lobo explains the basics of infertility, including causes, treatments and coping methods. Watch Video
Videos Icon

Surviving the Roller Coaster Emotions of Infertility Treatment

The experience of infertility is a rollercoaster of hope and disappointment. Treatment presents an opportunity for hope as well as a new set of challenges. Watch Video
Patient Ed Icon

Endometriosis (booklet)

Women with endometriosis may experience infertility, pelvic pain, or both. This booklet will describe options for diagnosing and treating pain or infertility that may be attributed to endometriosis. View the Booklet
Videos Icon

Causes of Female Infertility

Dr. Roger Lobo, of the American Society for Reproductive Medicine explains the causes of female infertility. Watch Video
Info Icon

FAQ About Infertility

Infertility is not an inconvenience; it's a disease of the reproductive system that impairs the body's ability to perform the basic function of reproduction. Learn the facts
Infographic Icon

Female Fertility Infographics

ASRM has prepared infographics to illustrate the subject of Female Fertility better. View the Infographics
Infographic Icon

Ovarian Reserve Infographics

ASRM has prepared infographics to illustrate the subject of Ovarian Reserve better. View the Infographics

Find a Health Professional

Connect with reproductive medicine experts who will guide you through your unique journey. Our search tool allows personalized matches based on location, specialization, and expertise. Take control of your reproductive health with compassionate providers, innovative treatments, and unwavering support.
Search for an Expert
Healthcare professional eager to help a patient