The following is a summary of “Effect of unicornuate uterus on reproductive outcomes in infertile patients,” published in the August 2024 issue of Obstetrics and Gynecology by Şimşek et al.

The unicornuate uterus, a rare congenital anomaly, is associated with a heightened risk of obstetric and perinatal complications. This study aims to assess the reproductive outcomes of patients with a unicornuate uterus and to compare these outcomes with those of patients who are infertile without Müllerian anomalies. A retrospective analysis was conducted on the data of patients who are infertile aged 18–40 years who were diagnosed with a unicornuate uterus between January 2012 and December 2022. A control group of age- and infertility duration-matched patients without Müllerian anomalies was also compared. 

The study evaluated demographic characteristics, cycle parameters, and reproductive outcomes between the unicornuate uterus and control group. A total of 75 patients with a unicornuate uterus and 75 patients who are infertile without Müllerian anomalies were included. In total, 116 pregnancies were achieved in the unicornuate uterus group, compared to 91 in the control group. Notably, the unicornuate uterus group exhibited significantly higher rates of ectopic pregnancy (10.3% vs. 2.2%; OR = 5.53, 95% CI [1.17–26.21]) and malpresentation (29% vs. 0%; OR = 1.40, 95% CI [1.12–1.76]), as well as lower newborn birth weights in singleton pregnancies (3,000 g vs. 3,455 g, p = 0.005). However, no significant differences were observed between the two groups regarding other obstetric parameters, including live birth rates and preterm deliveries. 

The findings of this study suggest that while the unicornuate uterus represents a small subset of congenital uterine anomalies, it is associated with specific reproductive challenges, including an increased likelihood of ectopic pregnancy, malpresentation, and reduced birth weights. Despite these risks, live birth rates and the incidence of preterm deliveries did not significantly differ from those of patients without Müllerian anomalies. These findings underscore the importance of thorough counseling and close monitoring of patients with a unicornuate uterus during both reproductive treatment and pregnancy to manage potential complications effectively.

Source: sciencedirect.com/science/article/abs/pii/S0301211524004792