ASRM müllerian anomalies classification 2021

Fertil Steril. 2021 Nov;116(5):1238-1252. doi: 10.1016/j.fertnstert.2021.09.025.


There are many proposed classification systems for müllerian anomalies. The American Fertility Society (AFS) Classification from 1988 has been the most recognized and utilized. The advantages of this iconic classification include its simplicity, recognizability, and correlation with clinical pregnancy outcomes. However, the AFS classification has been criticized for its focus primarily on uterine anomalies, with exclusion of those of the vagina and cervix, its lack of clear diagnostic criteria, and its inability to classify complex aberrations. Despite this classification and others, the wide range of müllerian anomalies is still largely unknown and confusing to many providers. Consequently, müllerian anomalies may go undiagnosed for extended periods, receive inappropriate or inadequate surgical interventions, and result in persistent issues such as pain or loss of reproductive function. The American Society for Reproductive Medicine Task Force on Müllerian Anomalies Classification was formed and charged with designing a new classification. The Task Force set goals for a new classification and chose to base it on the iconic AFS classification from 1988 because of its simplicity and recognizability, while expanding and updating it to include all categories of anomalies. In addition, this was recognized as an opportunity to raise awareness of this area of medicine, educate providers and learners, and promote patient advocacy. Presented here is the new American Society for Reproductive Medicine Müllerian Anomalies Classification 2021.

MeSH terms

  • Cervix Uteri / abnormalities
  • Cervix Uteri / diagnostic imaging
  • Decision Support Techniques*
  • Female
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Mullerian Ducts / abnormalities
  • Mullerian Ducts / diagnostic imaging*
  • Predictive Value of Tests
  • Terminology as Topic*
  • Ultrasonography*
  • Urogenital Abnormalities / classification
  • Urogenital Abnormalities / diagnostic imaging*
  • Uterus / abnormalities*
  • Uterus / diagnostic imaging
  • Vagina / abnormalities
  • Vagina / diagnostic imaging*

Supplementary concepts

  • Uterine Anomalies