Mullerian Duct Anomalies Causes, Symptoms & Treatment
What are Mullerian Duct Anomalies?
Mullerian Duct Anomalies (MDAs) are something some women are born with. It happens while a baby girl is growing in the womb (during fetal development). This is usually around 2 or 3 months into pregnancy. That is when the parts that make her female reproductive organs are forming and joining together. These organs are the uterus, fallopian tubes, and upper vagina.
These parts come from special tubes called mullerian ducts (paramesonephric ducts). If these ducts don’t grow or join the right way, it can lead to unusual shapes or missing parts in the uterus.
Who can get Mullerian Duct Anomalies?
It can happen to any woman. Doctors don’t really know why it happens to some and not others. When a baby is growing in the womb, they start with two sets of tubes: Mullerian ducts and Wolffian ducts (also called mesonephric ducts).
Usually, in boys, the mullerian ducts go away. But with Persistent Mullerian Duct Syndrome (PMDS), these tubes remain in the body. So, some boys end up with some female parts inside. This is often found when they have surgery for inguinal hernias (a medical condition where soft tissue bulges form in the lower abdomen).
What Types of Mullerian Anomalies Exist?
Mullerian anomalies can be different for each person suffering from them. They can affect different reproductive parts in various ways. These are some of the common ways:
- Agenesis & Hypoplasia: This is when parts of the girl’s or woman’s reproductive system don’t grow or only grow a little bit.
- Unicornuate Uterus: Here, the uterus (womb) looks like the shape of a banana. Additionally, only one of the mullerian ducts develops fully. It’s not very common and sometimes comes with kidney problems.
- Uterus Didelphys: This is like having two separate wombs. It happens when the two tubes don’t join together, so there are two different spaces in the womb. In some cases, there are even two cervices and vaginas.
- Bicornuate Uterus: This is the most common one. Here, the womb has two ‘horns’ (two upper cavities). It looks a bit like a heart because the tubes are only partly joined. This can sometimes mean there’s less room for a baby to grow.
- Septate Uterus: There’s a wall of tissue (septum) inside the womb that divides it, either partway or all the way. This can make it more likely to have a miscarriage.
- Arcuate Uterus: This is a very slight dip at the top of the womb and is often just seen as a normal difference in how wombs can look.
- DES-related Uterus: If a mother took a drug called DES (diethylstilbestrol) when she was pregnant, it could cause her daughter to have a womb shaped like a ‘T’.
What are the Causes of Mullerian Duct Anomalies?
As mentioned earlier, the exact reason is not clear. However, there are a few factors that seem to be responsible. Mullerian duct anomalies usually result from a mix of:
- Some genes (genetic factors) that are responsible for it are transferred from the parents.
- Certain hormone imbalances while the baby is growing in the womb can cause this to happen.
- Surroundings (environmental factors) are also responsible for it sometimes. They can expose the baby to harmful toxins and infections.
What are the Symptoms of Mullerian Duct Anomalies?
Sometimes, you might not even know you have müllerian duct anomalies. But other times, they can cause signs like:
- Abdominal pain without period
- Abnormal bleeding from your uterus
- Chronic pelvic pain
- Losing pregnancies more than once
- Trouble getting pregnant (infertility)
- Giving birth too early (Premature delivery)
- Finding out you have an abnormally shaped uterus when you’re pregnant or getting a check-up.
Does Mullerian Duct Anomalies Affect Fertility?
Yep, mullerian duct anomalies (also known as Mullerian malformations) can sometimes make it harder to get pregnant. It depends on the type of MDA, or how bad it is. For example, if the womb has a wall inside it (that’s a septate uterus), it can cause problems. It can prevent the baby from attaching properly and result in a miscarriage.
How are Mullerian Anomalies Diagnosed?
Usually, doctors find out about mullerian anomalies when a young girl’s periods start late or aren’t normal. Or, if a woman has trouble getting pregnant or keeps having miscarriages, they might look for mullerian defects.
- Pelvic Ultrasound: It is a non-invasive scan that creates images of your uterus and ovaries.
- 3D Ultrasound: It gives more detailed three-dimensional images that show the shape of your womb better.
- Magnetic Resonance Imaging MRI: This method provides high-resolution images of soft tissues inside the female reproductive tract. This helps in detecting complex anomalies.
- Hysterosalpingogram (HSG): An X-ray where the doctors put a little dye to see the inside of your reproductive system (the uterus and fallopian tubes).
- Laparoscopy: A small surgery where they put a tiny camera inside to examine your reproductive organs directly.
How are Mullerian Duct Anomalies Treated?
How doctors treat MDAs depends on the kind of uterine mullerian anomalies you have. If it’s not disturbing your ability to have kids, you might not need any treatment. If it’s not causing you discomfort or pain, then it should also be treated.
If treatment is necessary, these are some of the approaches used:
- Hormonal therapy is there for managing irregular cycles.
- Surgical intervention is done for septum removal.
- IVF or surrogacy is suggested if you are dealing with infertility.
- Uterine transplant is rarely done. This is for the cases where the uterus is absent.
The Bottom Line
Mullerian duct anomalies may sound tricky and scary, but there are solutions. Doctors can do surgery to fix these issues. This can make it easier to get pregnant and have healthy pregnancy outcomes. So, if a woman is having trouble getting pregnant, she should talk to a fertility doctor. This will help her find out what’s going on and how to help.