Bicornuate uterus

Case contributed by Bahman Rasuli
Diagnosis almost certain

Presentation

Workup for infertility.

Patient Data

Age: 35 years
Gender: Female
Fluoroscopy

A divided uterus is seen. 

Normal spillage is noted bilaterally.

Case Discussion

Hysterosalpingogram accuracy in differentiation between uterus septate vs uterus bicornuate is only 55%.  The angle between the uterine horns less than 75°  is suggestive of a septate uterus while an angle of more than 105° is more suggestive of a bicornuate uterus. This differentiation is critical because the bicornuate uterus does not pose fertility-related issues. In this case on ultrasound evaluation (not shown), a bicornuate uterus was confirmed. It can be classified as a class IV Mullerian duct anomaly.

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