Could a congenital abnormality cause recurrent miscarriages?

Fertil Steril. 2002 Nov;78(5):899-915.

Female genital anomalies affecting reproduction. Lin PC , Bhatnagar KP , Nettleton GS , Nakajima ST .

Division of Reproductive Endocrinology and Infertitlity, University of Washington School of Medicine, Seattle, Washington 98105, USA. linner@u.washington.edu

Objectives:

A multitude of female congenital anomalies are uncommon. However, their impact on reproduction can be profound. The aim of this review is to remind the practicing physician of the clinically relevant embryology and summarize the studies that look at the impact of such various anomalies on a woman's fecundity. We review particular surgical therapies that possibly may improve fertility in such women.

Design:

Review and critique of available studies in which particular surgical therapies were done and whether they truly improved fertility in these women with congenital reproductive anomalies.

Results:

Clear evidence demonstrates that uterine septum resection is effective in women with demonstrated recurrent pregnancy losses. Arcuate uterus has little impact on reproduction. Other studies fail to definitively show that surgical correction will improve pregnancy retention or fertility except for specifically indicated clinical scenarios.

Conclusions:

The practicing reproductive specialist should have working knowledge of evidence-based therapeutic options for women with reproductive congenital anomalies. A summary chart has been devised to clearly associate embryologic structures with normal adult derivative as well as anomalous structures.

Please click on the required question.

• 1  What is a miscarriage?
• 2  What are the different types of miscarriage?
• 3  How accurate are pregnancy tests?
• 4 What is a blighted ovum?
• 5 I have had a hydatidiform mole. What is this?
• 6 Why did I have a spontaneous miscarriage?
• 7 How frequently do miscarriages occur?
• 8 I am miscarrying. How should this be treated?
• 8a Can miscarriage result in anxiety and depression?
•  9 What is meant by recurrent miscarriage?
• 10 I have a problem with recurrent miscarriage. What is the chance of my next pregnancy being successful?
• Q 12.11 Recurrent Miscarriage I have miscarried again. Why does this keep happening?
• 12 What congenital problems might be associated with recurrent miscarriage and how could they be treated?
• 13 What traumatic conditions can cause recurrent miscarriage and how can they be treated?
• 14 Can infection cause recurrent miscarriage and would treatment help?
• 15 Could a metabolic disorder cause recurrent miscarriage?
• 16 Could a hormonal problem account for recurrent miscarriage and would hormone treatment help me?
• 17 Could an autoimmune problem cause recurrent miscarriage and how could this be treated?
• 18 Could a tumour cause recurrent miscarriage?
• 19 What degenerative processes may be associated with recurrent miscarriage?
• 20 After every miscarriage I become more depressed. Could this account for the problem?
• 21 Is it always possible to explain recurrent miscarriage?
• 22 I have a problem with recurrent miscarriage. What treatment is available to ensure that this does not happen again?
• 23 What is an ectopic pregnancy?
• 24 How frequently do ectopic pregnancies occur?
• 25 Why do ectopic pregnancies occur?
• 26 How can an ectopic pregnancy be diagnosed?
• 27 How can an ectopic pregnancy be treated?
• 28 Where can I obtain more information?
• 29 Support Groups.
  

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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.

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