Can You Have a Baby if You Have a Bicornuate Uterus?

A bicornuate uterus is classified into two types depending on the division of the cervix:

1. Bicornuate unicollis uterus: The indentation that starts at the top of the uterus reaches only half of the uterus. Though it appears to have two uterine cavities from the outside, there is only one cavity inside.
2. Bicornuate bicollis uterus: The indentation that starts at the top of the uterus reaches the bottom of the uterus and divides the uterus into two cavities and presents as two uteruses, although it is a single uterus.

Women with a bicornuate uterus may not experience any symptoms. Asymptomatic women are first diagnosed with the condition after having an ultrasound or other imaging tests of the abdomen. 

However, a few women with bicornuate uterus may experience the following symptoms:

• Abdominal pain and discomfort
• Pain during the period (dysmenorrhea)
• Abnormal and irregular vaginal bleeding
• Pain and discomfort during intercourse
• Frequent miscarriages

Young women without any uterine abnormalities may experience these symptoms as well, so diagnosis should not be made solely based on symptoms.

Women may be diagnosed during a routine ultrasound scan when they are pregnant or if they are experiencing symptoms. Women with irregular bleeding, repeated miscarriages, and painful periods should see a doctor.

Investigations that help diagnose a bicornuate uterus include:

• Pelvic examination
• Hysterosalpingogram, during which special dye is injected into the uterus, and X-rays are used to take images of the uterus and fallopian tubes (this imaging technique shows any deformities in the womb)
• High-frequency ultrasound waves are used to create the outlines of the uterus and its contents.
• Strong magnetic fields and radio waves are used in magnetic resonance imaging (MRI) to provide detailed images of the uterus

The only treatment option for a bicornuate uterus is surgery, although most women will not require surgery to correct a bicornuate uterus.

Strassman’s metroplasty may be done to repair a bicornuate uterus in a woman who has a history of miscarriage. Laparoscopic Strassman's metroplasty is less invasive than abdominal Strassman's metroplasty. Though Strassman's metroplasty is an invasive procedure, abdominal Strassman's metroplasty has been found to be more beneficial because it increases the number of successful deliveries.

In one study, 88% of individuals who underwent a Strassman’s metroplasty had successful pregnancies and gave birth to healthy children through Cesarean delivery.

Another study found that abdominal metroplasty increased live birth rates from 3.7% to 80%.