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Bicornuate vs septate uterus (hysterosalpingogram)

Case contributed by Bahman Rasuli
Diagnosis almost certain

Presentation

Workup for infertility.

Patient Data

Age: 35 years
Gender: Female

The endometrial cavity is divided, suggestive of a bicornuate uterus or a septate uterus.

The angle between the uterine horns is obtuse (118°).

Bilateral proximal tubal occlusion.

No spillage is noted bilaterally.

Case Discussion

Hysterosalpingogram accuracy in differentiation between septate uterus vs bicornuate uterus 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.

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