Septate, Arcuate, Bicornuate, and Didelphic Uteri
Uterine duplication, a generic term commonly used throughout the literature, has fascinated anatomists, embryologists, and clinicians. These abnormalities provide a keyhole view of the early embryology of the female reproductive tract, prompt questions regarding structure and function and challenge clinical management. The interest is longstanding. The earliest description of a “double uterus” was in 1681 by Dionis, who published a case report describing simultaneous pregnancies in each hemi-uterus.1 In 1859, Kussmaul described in detail a double uterus in autopsy findings of a stillbirth. In 1894, Pfannenstiel presented the first extended case series of 12 cases of uterine didelphys.2 These early reports were merely descriptive and no more than observational case series. The first report that systematically attempted to address the impact of uterine abnormalities on reproductive potential was published by Miller in 1922,3,4 and indicated no change in fertility with a 91% pregnancy rate. Of these pregnancies, only 61% went to term.