Adolescent Reproductive Health: Information and Treatment Options for Reproductive Tract Disorders (Müllerian Anomalies)Adolescence is a significant phase of life for many reasons. For a young female, the onset of puberty brings about physical changes and a new awareness of her body. At times, underlying health conditions may surface during puberty. Some adolescents may experience issues with pelvic pain, irregular menstrual bleeding or other reproductive tract problems. One type of gynecologic condition that may be diagnosed during adolescence is called a müllerian anomaly.
Samantha Pfeifer, MD, a fertility specialist with Penn Fertility Care, answers your questions about müllerian anomalies. Dr. Pfeifer is a nationally recognized expert in adolescent gynecologic disorders affecting future reproduction.
What are müllerian anomalies?
Müllerian anomalies affect up to 4 percent of females. Dr. Pfeifers explains, “The anomaly is considered a ‘congenital disorder’, meaning it occurs during fetal development and is present at birth. As an embryo forms, two paired müllerian ducts develop into the female reproductive tract which includes the fallopian tubes, uterus, cervix, and upper two thirds of the vagina. A wide variety of malformations can occur when this system is disrupted.”
There is not one cause of müllerian anomalies. Some may be hereditary, others may be attributed to a random gene mutation or developmental defect.
What types of müllerian anomalies exist?
There are several different forms of müllerian anomalies, ranging from the absence of a uterus to the formation of a half uterus or double uterus, to a uterus divided by a septum.
All types affect the reproductive tract in varying degrees.
How is the condition diagnosed?
Müllerian anomalies are often recognized at the onset of puberty — when an adolescent begins to menstruate or when a young female fails to get her menstrual period. The condition may also be diagnosed when a woman has trouble conceiving or maintaining a pregnancy. Some anomalies are associated with abdominal or pelvic pain, discomfort during sex, or menstrual abnormalities.
“Imaging technology can diagnose a müllerian anomaly and may also detect other existing reproductive conditions. Diagnostic testing may include pelvic ultrasound, three dimensional ultrasound, magnetic resonance imaging (MRI), hysterosalpingogram (HSG), laparoscopy or hysteroscopy. A combination of tests may be recommended to establish the most accurate diagnosis,” states Dr. Pfeifer.
How are müllerian anomalies treated? Can a female with this condition eventually become pregnant and carry to term?
“In many cases, the condition can be left untreated, in particular when it does not significantly affect reproduction. Müllerian anomalies that prevent menstruation or cause significant pain are usually surgically treated. Surgical intervention depends on the extent of the individual problem. Müllerian anomalies that affect fertility such as a septated uterus (a partitioned uterus) can be corrected, thus improving chances of having a successful pregnancy,” states Dr. Pfeifer.
“Women with a congenital reproductive anomaly who have not been able to achieve pregnancy within six months of trying should see a fertility specialist skilled in reproductive surgery. Surgery can repair the defect, eliminate discomfort during menses or sexual relations and improve fertility and pregnancy outcomes,” states Dr. Pfeifer.
Adolescent Reproductive Health and Reproductive Surgery Services at Penn Fertility Care
Penn Fertility Care’s reproductive surgeons are experienced in caring for adolescents and women with müllerian anomalies and often work in collaboration with pediatric urologists at the Children’s Hospital of Philadelphia. As part of the Penn Center for Advanced Gynecologic Surgery, our physicians also offer surgical options to treat infertility and to preserve a woman’s reproductive function.
For more information or to make an appointment with a Penn Fertility Care specialist, please call 800-789-PENN (7366) or visit the Penn Fertlity Care Web site.
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