An unusual anatomic variation of a unicornuate uterus with normal external uterine morphology

Abstract

Objective: To describe a case of a unicornuate uterus with a normal external uterine morphology.

Design: Case report.

Setting: University-based fertility center.

Patient(s): A 30-year-old nulligravid woman with a 1-year history of infertility found to have a right proximal tubal occlusion on hysterosalpingogram.

Intervention(s): Laparoscopy, hysteroscopy, and magnetic resonance imaging.

Main outcome measure(s): External and internal morphology of the uterus.

Result(s): Laparoscopy showed a normal external uterine morphology and normal fallopian tubes and ovaries, but chromopertubation failed to demonstrate a fill and spill from the right fallopian tube. Hysteroscopy showed a single tubular uterine cavity projecting to the left with a single left tubal ostium, consistent with a unicornuate uterus. Magnetic resonance imaging confirmed a normal external uterine fundal contour and an internal uterine morphology consistent with a unicornuate uterus.

Conclusion(s): This is the first reported case of a unicornuate uterus presenting with a normal external uterine morphology and an internal morphology consistent with a unicornuate uterus, and we propose inclusion of this anomaly in the classification of mullerian anomalies.