Brief Answer:
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Detailed Answer:
Hello XXXXXXX
Thanks for writing to us with your health concern.
Firstly, HSG is not confirmatory to diagnose
bicornuate uterus.
I have gone through the HSG film, and there is definitely an abnormality in the shape of the uterus.
Bicornuate uterus means that the uterus is divided into two separate cavities, and a septate uterus means there is a fibrous septum or partition between the uterus, essentially a partition in one cavity.
HSG cannot differentiate between these two.
The diagnosis is only possible by
hysteroscopy combined with
laparoscopy.
However, both septate and bicornuate uterus have no association with fertility.
Conception is not an issue, but there is a higher risk of abortions with both these abnormal shapes of the uterus.
SO these should not lead to issues in conceiving.
Rarely, bicornuate uterus is complete ( didelphys ) and then there could be partition in the vagina too, and that might lead to fertility issues.
Basically go for the following steps -
1.
Semen analysis is normal, nothing needs to be done.
2. FSH is low, please go for AMH levels to know the ovarian capacity to form mature eggs. ALso have TSH screening.
3. You are already going for one cycle of follicular monitoring with stimulation using Ovofer 100. During that cycle, you would know how well you are ovulating. You can go for 3 - 6 cycles of follicular monitoring with
ovarian stimulation. If these cycles fail, then you need to go for a laparoscopy and hysteroscopy to confirm that fallopian tubes are indeed open and to confirm type of uterine abnormality.
4. Take regular
folic acid supplements and maintain ideal weight.
5. If 6 cycles of stimulation fail ( you can combine them with IUI intra uterine insemination ) for better results then you can consider IVF next.
6. If laparoscopy reveals a major abnormality in uterine shape, then corrective surgery can be done simultaneously at the same sitting.
7. Meanwhile, have a thorough gynecological check up to ensure that there is no vaginal septum.
Do not stress out more, as bicornuate uterus is not an obstacle to conception.More than 90 % of women with a bicornuate uterus achieve a successful pregnancy and delivery. If you conceive, chances of
miscarriage / abortion can be minimized by taking measures like a cervical stitch / giving stronger medications to avoid abortions.
All the best.
Please feel free to ask for further clarifications.