Uterine Didelphys - A Layman's Guide to This Reproductive Anomaly

I suffer from a rare uterine deformity called Uterine Didelphys. If mentioned, it confuses people, so I thought, "Hey! I'll write an article on it!" Never let it be said I don't take my writing straight from my life.

Uterine Didelphys is an anomaly resulting from the Mullers ducts not fusing in development. Here's a nice technical definition for you:

Uterine Didelphys is a rare type of deformity (1 in 1000 women) in the female reproductive organs in which some organs may be either split or duplicated. Typically, some of these "extra" organs are non-functional or semi-functional appendages, although on occasion they will be completely functional in all normal respects, and often independently. As the vagina is largely derived from the Mullerian ducts, lack of fusion of the two ducts can lead to the formation of a vaginal septum, or "double vagina", a condition sometimes called with a uterus didelphys or a uterine septum.

In my personal case, I have two completely separate organs, with two cervixes. I have only the two normal ovaries, one is connected to each. I also used to have the vaginal septum as well; however, I finally had that removed surgically. In addition, I suffer from fibroids, but my research indicated that it has nothing to do with my congenital defect.

So what does this mean to a woman? Well, as far as practical matters go, I menstruate in each, at the same time - so tampons couldn't be used due to the septum (the blood would just run down the other side of the septum). When I menstruate, I have double the pain (both uteri contracting for cramps), and double the blood (both uteri shedding their linings). In addition, intercourse was a pain - on both sides. Imagine if you will, the male party doing the thing that he does, when Bam! He hits a wall dead on. Let's just say my husband was happy after the septum removal as well.

I've often been asked, "Why don't you just have one of them removed?" The answer I've received from my various doctors was that they were loathe to remove a healthy organ - the risks of general anesthesia outweighed the benefits. You see, it's already done, so to speak. I can't make the remaining one larger (they are both smaller than an average uterus). I can't reduce my risk of miscarriage. And the usual course of action would be hormonal birth control to help with the pain and blood loss. In my personal case, there's too much risk of migraines and stroke, although that's a strong help to other women. In addition, a hysterectomy is out for me, unless I needed it for another reason such as cancer or an injury etc. as the hormone therapy afterwards would be just as bad as the birth control for my migraines.

So, I'm stuck between a rock and a hard place.

As far as pregnancy goes, getting pregnant isn't the problem, but staying pregnant is. There is a higher risk of miscarriage. The uterus could potentially be too small to stretch large enough for the fetus. Also, for the same reason, there is risk of an incompetent cervix, and sometimes a cerclage is necessary. In my personal case, I've had two vaginally born sons. One was a little early, and one was full term. While I did have some complications with both of them, they weren't related to my didelphys. The pregnancies, however, were labeled as higher risk. With women with didelphys, unusual fetal positions are more common, so the chance of cesarean is high.

And the number one question I get is, "Can you get pregnant in both at the same time?" The answer is yes. I did not. It is unusual, but it is possible. It is also possible for those babies to be born at different times.

One of the more important things for these women to remember is that the defect is associated with kidney abnormalities. Please make sure, if you're diagnosed, that an ultrasound is taken of your kidneys.

Some signs you may have Uterine Didelphys:A mass in the pelvis
Unusual pain before or during a menstrual period
Abnormal bleeding during a period, such as blood flow despite the use of a tampon

Having this congenital defect is an interesting life circumstance. I mean, how many women are unusual enough that they commonly are asked by their doctors if their students can join in on your exams? Of course, you may get a little annoyed with the revolving door peepshow down there. The bottom line is, you have to have knowledge for your health, but this is by no means a debilitating condition. Learn your body, speak with your medical professional of choice, and know what's going on. Then you have the ability to make educated choices with your medical care.

Sources used:
http://www.medcyclopaedia.com/library/topics/volume_iv_2/u/uterus_didelphys.aspx
http://www.doctorslounge.com/fertility/articles/anomalies/anomalies3.htm
http://en.wikipedia.org/wiki/Uterine_malformation