Mullerian anomalies behind 4-5 percent infertility among Indian women

New Delhi : Mullerian anomalies, or a defect in the development of uterus and fallopian tubes, is the basic reason for infertility among 4-5 per cent of women in India, said doctors.

According to them, other than infertility, the anomalies can cause recurrent miscarriages and create difficulties in carrying a pregnancy to term.

"Abnormal uterus may affect a woman's chance of getting pregnant. In fact, around 10 per cent of all cases of female infertility are caused by an abnormal uterus. Sometimes, defects of the uterus can occur during the development period of foetus in utero," said Sagarika Agarwal, an IVF expert associated with city-based Indira IVF.

Agarwal, who has received a number of such cases, said: "Like other organs in the body, a woman's reproductive organs form while she is still a foetus inside her mother's uterus. Any defect in the development of uterus and fallopian tubes causes the entire defect. There are many types of mullerian anomalies, right from the absence of uterus to complete duplication of the uterus, cervix, and vagina (didelphys)."

According to medical sciences, there are various type of abnormalities, including agenesis in which there is absence of vagina or uterus or both. This is usually picked up when a girl doesn't start her periods by the age of 12-13 years. In the later part of life, vaginal agenesis can affect her sexual life, but this can be treated with surgery.

In another similar abnormality named unicornuate uterus, there is only one fallopian tube.

"It is a rare abnormality. If a woman has unicornuate uterus, she probably will have two ovaries. Only one will be connected to the uterus, though. As long as there is one, healthy, developed horn, it is perfectly possible to conceive. However, it does put her at greater risk of miscarriage and preterm delivery," said Manjula B.C., an Bengaluru-based IVF specialist, told IANS.

Stating that with the change in time the number of women with mullerian anomalies is being witnessed in evey one among 20 women, she said : "In many cases abnormal uterus causes no problems and infact may remain undetected until period of menarche or till pregnancy is attempted."

However, "if a uterine anomaly such as in unicornuate uterus is associated with a rudimentary uterine horn with no outlet, menstrual outflow will be obstructed".

"This can result in pain that gets worse during periods. If untreated, blood collects in the uterus and may become infected. A uterine abnormality may also be associated with infertility, ectopic pregnancy, recurrent miscarriage, premature delivery, dysmenorrhoea and abnormal bleeding," said Manjula.