Uterine hypoplasia – a malformed uterus

A child can be born with a small or malformed uterus, also known as a hypoplastic uterus or uterine hypoplasia. This is an anatomical abnormality (congenital disorder), meaning the child is built like that in the womb after the uterus fails to develop properly.

Uterine hypoplasia can be related to MRKH, a condition whereby the uterus and vagina are not present or are underdeveloped. There may be other abnormalities.

Symptoms of uterine hypoplasia

  • Failure to menstruate (primary amenorrhoea)
  • Pain in the abdomen
  • Small vaginal opening
  • No vaginal opening
  • Infertility

Diagnosis of uterine hypoplasia
The genitals usually appear completely normal, so this is usually diagnosed at puberty or just after, when an adolescent girl doesn’t get her period and help is sought for the reason. A pelvic examination will be performed, with blood tests done, an ultrasound conducted, and possibly an MRI to determine the extent of the abnormalities.

Types of uterine hypoplasia
You could have various presentations of uterine hypoplasia, with various outcomes in terms of fertility and menstruation.

  1. Simple hypoplasia
    Uterus is normally formed, but small
  2. Elongated hypoplasia
    Fundus is normal, but uterus is long
  3. Malformative hypoplasia
    Uterus shaped abnormally, for example bowed or T- or Y-shaped

What uterine hypoplasia looks like in real life – outcomes
Everyone with uterine hypoplasia will have a slightly different variation from others, with different elements of other abnormalities present. For example, one might have also a malformed vagina, while another may have every other part of her anatomy fully functional and formed.

Often the formation of what’s known as ‘secondary sex characteristics’ is indicative of ovarian function, which is a bonus. This can mean that egg retrieval is possible.