There are many classification systems for congenital utero-vaginal anomalies. These include:

• Buttram and Gibbons classification ²
• American Fertility Society (AFS) classification
• Modified Rock and Adam - AFS classification

Modified Rock and Adam - AFS classification

This classification divides congenital uterine anomalies into four main types:

• class I: dysgenesis of Müllerian ducts
  • includes agenesis or hypoplasia of the müllerian duct derivatives: the uterus and upper two-thirds of the vagina
  • the most common form is the Mayer-Rokitansky-Kuster-Hauser syndrome which is the combined agenesis of the uterus, cervix, and upper portion of the vagina
• class II: disorders of vertical fusion
  • these anomalies are due to failure of fusion of the müllerian system with the sinovaginal bulb
  • they include cervical dysgenesis and obstructive and nonobstructive transverse vaginal septa
• class III: disorders of lateral fusion
  • describes anomalies that result in a duplicated or partially duplicated reproductive tract
  • these disorders are due to impaired fusion and/or septal resorption of fusing Müllerian ducts attempting to form the uterus, cervix, and upper vagina
  • it includes anomalies due to failure of fusion of the paired müllerian ducts (as in didelphic and bicornuate uteri) and failure of midline septum resorption after fusion (as in septate uterus)
  • disorders due to lateral fusion defects are further subclassified into 
    • a: symmetric non-obstructive forms seen in five types: unicornuate, bicornuate, didelphic, septate, and DES-related uteri
    • b: asymmetric obstructive forms seen in three types: unicornuate uterus with obstructed horn, double uterus with unilaterally obstructed horn, and double uterus with unilaterally obstructed vagina
• class IV: unusual configurations and combinations of defects