A retroverted uterus is something often written on scan reports. It means that the womb tilts backwards towards the rectum or spine. This is a natural anatomical variation of position which happens in about one quarter of women. The most common position for a womb to lie in is anteverted or forwards over the bladder. Another normal variation found in some women is the upright uterus, where the top of the womb is straight up, otherwise known as axial. A retroverted uterus does not affect fertility or the ability to conceive nor does it affect success with fertility treatment.

Rarely, a retroverted uterus is due to a disease such as endometriosis (where the lining of the womb, endometrium, can get into the pelvis outside the womb), an infection or prior surgery, all of which can cause adhesions or scarring which can pull the uterus back. It is these conditions, but not the position of the uterus itself, that can lead to fertility problems in some cases. In the majority of cases women will not know that their uterus is retroverted and will have no symptoms.   Very occasionally will women experience symptoms such as painful sex or painful periods which are usually caused by endometriosis or adhesions/ scar tissue. Other causes of a retoverted uterus are fibroids which are non cancerous lumps which can make the womb heavier and tilt back and pregnancy itself.

A retroverted uterus will usually move to the middle of the pelvis during the 10th to 12th week of pregnancy as the uterus lifts up out of the pelvis with the growing baby. A retroverted uterus does not increase the rate of miscarriage or ectopic pregnancy. It does not directly lead to pre term birth.

A retroverted uterus is diagnosed on scan or pelvic examination.

Normally a retroverted uterus requires no treatment. If it is caused by endometriosis or adhesions these can sometimes be treated surgically and/or by hormone treatment in the case of endometriosis.

Dr Sarah Merritt

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