Journal of International Reproductive Health/Family Planning ›› 2025, Vol. 44 ›› Issue (6): 506-510.doi: 10.12280/gjszjk.20250320

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Research Progress on Diagnosis and Treatment of Arcuate Uterus

ZHANG Dong-can, HE Ling, ZHANG Hui-ying, TIAN Wen-yan()   

  1. Department of Obstetrics and Gynecology, Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Tianjin Medical University General Hospital, Tianjin 300052, China
  • Received:2025-06-20 Published:2025-11-15 Online:2025-11-18
  • Contact: TIAN Wen-yan, E-mail: tianwenyan1108@163.com

Abstract:

Arcuate uterus is a relatively common type of congenital uterine malformation, resulting from incomplete absorption of the median septum during the process of müllerian duct fusion. It is characterized by a mild indentation of the endometrium at the fundus into the uterine cavity. The diagnostic methods and criteria for arcuate uterus vary across studies. Typically, the depth of indentation of the endometrium at the fundus is less than 1 cm, and the central angle of the indentation is usually greater than 90 degrees. Three-dimensional ultrasonography, magnetic resonance imaging, hysteroscopy, and/or laparoscopy can aid in the diagnosis. The current relationship between arcuate uterus and adverse pregnancy outcomes remains unclear. The patients with arcuate uterus complicated by infertility, recurrent miscarriage, or poor obstetric outcomes may undergo surgical treatment, which is performed via hysteroscopic metroplasty for arcuate uterus. The therapeutic efficacy of surgery is a subject of controversy among different studies. In this article, we review the definition and diagnostic criteria, diagnostic methods, impact on pregnancy outcomes, surgical indications, and postoperative pregnancy outcomes of arcuate uterus, to offer new insights for the individualized diagnosis and treatment of arcuate uterus and further enhance female fertility.

Key words: Congenital abnormalities, Pregnancy outcome, Arcuate uterus, Müllerian anomalies, Three-dimensional ultrasound