Diagnosis of Mullerian anomalies in adults: evaluation of practice

Fertil Steril. 2008 Jan;89(1):219-22. doi: 10.1016/j.fertnstert.2007.02.044. Epub 2007 May 4.


Objective: To evaluate the circumstances associated with the diagnosis of Mullerian anomalies in adults.

Design: Retrospective observational study.

Setting: University hospital.

Patient(s): All patients with Mullerian anomalies referred for evaluation.

Intervention(s): All patients underwent radiologic and operative diagnostic workup using ultrasonography, or ultrasonography and hysteroscopy, and in some cases laparoscopy.

Main outcome measure(s): Clinical symptoms and radiologic investigations leading to the diagnosis. Mode and number of investigations before the diagnosis, and the time since the initial symptoms to the final diagnosis.

Result(s): One hundred ten patients were diagnosed with Mullerian anomalies: 73 septate uteri, 20 bicornuate uteri, 10 uterine hypoplasia, 4 unicornuate uteri, and 3 with Mayer- Mayer-Rokitansy-Küster-Hauser syndrome. The circumstances leading to the diagnosis were infertility (33.6%), repeat miscarriage (18.2%), ultrasonography during pregnancy (12.7%), pregnancy complications during last trimester (11%), abnormal examination (8.2%), and miscellaneous causes (16.3%). Up 50% of patients complained of gynecologic signs before the appropriate diagnosis. Radiologic diagnosis required two complementary imaging techniques in 62% of patients and more than two in 28%. The correct diagnosis was established in only 40% of cases before hospitalization. Most of the anomalies were initially diagnosed at hysterosalpingography and ultrasonography. The mean time between the first imaging examination and the diagnosis in a specialized department was 6.7 (+/-7.1) months.

Conclusion(s): The diagnosis of Mullerian anomalies in adults is often made at the time of conception and obstetric complications. There is a tendency toward the use of multiple imaging techniques and this delayed the diagnosis.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Congenital Abnormalities / diagnosis*
  • Congenital Abnormalities / pathology
  • Diagnostic Techniques, Obstetrical and Gynecological*
  • Female
  • Humans
  • Hysterosalpingography
  • Hysteroscopy
  • Laparoscopy
  • Magnetic Resonance Imaging
  • Mullerian Ducts / abnormalities
  • Mullerian Ducts / pathology*
  • Practice Guidelines as Topic
  • Predictive Value of Tests
  • Retrospective Studies
  • Sensitivity and Specificity
  • Time Factors
  • Tomography, X-Ray Computed
  • Ultrasonography