Infantile/hypoplastic uterus

Infantile/hypoplastic uterus

Infantile uterus is a form of uterine malformation where the size of the uterus is smaller than normal.

There are two subtypes of infantile uterus:

1- The fetal uterus: where growth is interrupted “immediately at birth” and the dimensions of the uterus do not reach more than 3 centimeters (almost no uterine chamber exists at all), which leads to the absence of the menstrual cycle and infertility.

2- Childhood uterus: where the growth of the uterus stops during childhood and the size of the uterus does not reach more than 3-5.5 centimeters. This condition is better than the condition of the fetal uterus as the chances of pregnancy are higher, but the woman is more vulnerable to recurrent miscarriages and premature births.

What is the normal size of an adult female's uterus?

55-70 mm (5.5-7 cm)

What are the causes of infantile uterus?

- Malnutrition in infancy or in childhood.

- Genetic factors.

- An infection affecting the fetus or an infection affecting the female during childhood, such as recurrent respiratory infections and influenza.

- Excessive vigorous exercise during childhood.

- Family history of infantile uterus syndrome.

- Use of certain medications and exposure to nicotine or narcotic substances.

- Hormone deficiency due to hypogonadism.

- Continuous severe psychological stress that affects the function of the hypothalamus in the brain.

- Severe vitamin deficiency in childhood.

- Performing surgeries on female ovaries during childhood.

- Viral infections that affect the female ovaries in childhood, such as mumps, measles or rubella.

What are the signs of infantile uterus?

- At puberty, the female reproductive system develops, which leads to external physical manifestations that reflect that the development of the reproductive system is healthy, such as (the first menstrual period, the armpit and pubic hair, breast development) ... In the case of an infantile uterus, the menstrual cycle is absent (the first menstrual period does not occur). In some cases of the infantile uterus, a menstrual cycle may occur after the age of 16 years, but it is very light and irregular, and is accompanied by very severe pain during the period. The patient’s first visit may be due to fertility problems, lack of sexual desire, and difficulty in reaching orgasm.

How is infantile uterus diagnosed?

- The medical history, which in most cases shows the absence of the menstrual cycle (amenorrhea) since puberty.

- The patient's first visit may be due to fertility problems.

- Ultrasound examination (abdominal or transvaginal) with measurement of the size and dimensions of the uterus, which appears to be smaller than normal.

- In some cases, we may resort to a hysteroscopy or a hysterosalpingography to evaluate the size of the uterine chamber and the severity of the problem.

- In some cases, we may resort to hormonal tests to determine whether the cause of the infantile uterus is hypogonadism.

What is the external appearance of women who suffer from an infantile uterus?

The following signs may be present:

- Short stature

- Skinny women

- Breast size is small

- The pelvis is small

- The amount of pubic hair is light

- Underdeveloped labia.

Is pregnancy possible in cases of infantile uterus?

Yes, it is possible, but this depends on the size of the uterus. The pregnancy may be normal and without any problems in cases of mild infantile uterus, or the woman may suffer from repeated miscarriages and premature births in severe cases.

Is there a treatment for infantile uterus?

- There are experimental surgical treatments aimed at increasing the size of the uterine chamber, but their effectiveness has not been proven for everyone, and they differ from one case to another (depending on the degree of uterine growth deficiency).

- Hormonal treatments can be given (especially in cases of infantile uterus due to hypogonadism). These hormonal treatments are represented by the hormones estrogen and progesterone, which are given over a period of 3-6 months with the aim of increasing the size of the uterus under their influence.

- In vitro fertilization for the purposes of infertility and pregnancy. In severe cases (lack of a uterine chamber), we may have to implant the embryos in the surrogate mother.

Note: Surrogate mothers are prohibited in some countries for religious/social/cultural reasons, but are permitted in other regions of the world.

Dr Najeeb Layyous F.R.C.O.G

Consultant Obstetrician, Gynecologist and Infertility Specialist