Is I-shaped uterus more common in patients with hyperandrogenism?

Eur J Obstet Gynecol Reprod Biol. 2022 May:272:116-122. doi: 10.1016/j.ejogrb.2022.03.018. Epub 2022 Mar 10.


Objectives: Subtypes of T-shaped uterus are rare uterine cavity anomalies and there are no morphometric criteria for the diagnosis. Earlier we established a high frequency of I-shaped uterus in patients with adrenalhyperandrogenism, which is more common in Armenian populations. The aim of the study was to determine the frequency of I-shaped uterus as a subtype of T-shaped uterus in patients with ovarian and adrenal hyperandrogenism, accompanied by infertility and miscarriage, as well as the development of it's ultrasonic morphometric criteria.

Study design: We conducted an ultrasound of 486 patients aged 19-40 years (mean 30.1 ± 5.5) who applied for infertility or habitual pregnancy loss.74 of them were diagnosed with the PCOS (Polycystic ovary syndrome) and 43-CAH (congenital adrenal hyperplasia). Ultrasound was performed in early luteal phase. The classification of uterine cavities was carried out according ESHRE/ESGE.

Results: 299 had normal ultrasound morphology of the uterine cavity, 20.7% various uterine cavity abnormalities. T-shaped uterus was observed in 3.7%, I-shaped uterus exclusively in patients with hyperandrogenism, 24.3% with PCOS and 39.5% with CAH. To determine the relevant morphometric features as diagnostic criteria for the I-shaped uterus some measurements were performed. The values of dist1-dist2 and dist1-dist3 in the normal cavity had a significant difference (P1-2 0.3), also the cavity width in the middle third and the isthmic section did not have a significant difference (P > 0.05), while in the normal cavity shape these values were significantly different (P < 0.05).

Conclusion: Frequency of occurrence of the T-shaped uterus did not exceed that in comparison with a group of women with other causes of infertility, while I-shaped congenital anomaly of the uterine cavity was found in 24.3-39.5% patients with hyperandrogenism. The difference between the interostial and corporal distances and the interostial and isthmic distances was the most relevant morphometric attribute of I-shaped uterus.

Keywords: Hyperandrogenism; I-shaped uterus; Infertility; Three-dimensional ultrasound.

MeSH terms

  • Abortion, Spontaneous*
  • Female
  • Humans
  • Hyperandrogenism* / complications
  • Infertility*
  • Polycystic Ovary Syndrome* / complications
  • Polycystic Ovary Syndrome* / diagnostic imaging
  • Pregnancy
  • Urogenital Abnormalities
  • Uterus / abnormalities
  • Uterus / diagnostic imaging

Supplementary concepts

  • Uterine Anomalies