Sonographic evaluation of mullerian anomalies in women with polycystic ovaries


Background: Mullerian anomalies are relatively common and contributing to the problems of infertility and poor pregnancy outcomes. But their molecular pathophysiology has been insufficiently studied. On the other hand, polycystic ovary syndrome (PCOS) is found in nearly 80% of women with hyperandrogenism and also in 8%-25% of normal ones. It seems that anti-mullerian hormone (AMH) which inhibits the formation of the mullerian ducts in male increases in women with PCOS. Therefore, the aim of the study is whether PCOS is associated with mullerian anomalies. Methods: In this case-control study, 83 women with PCOS and 83 cases without PCOS were evaluated with transvaginal ultrasound (TVS) for the diagnosis of mullerian anomalies. The results of each group were compared with other groups. Results: In the PCOS patients, TVS revealed mullerian anomalies in the uterine cavity in 29 out of 83 women. Among 29 patients who had lesions in their uterine cavity, 27 cases had septate uterus and two had arcuate uterus. In the healthy women, TVS revealed 6 septate uterus and 4 arcuate uterus abnormality cases of the uterine cavity. There were significant correlation between polycystic ovary syndrome of the patients and the mullerian anomalies lesions (i.e. septate and arcuate uterus) which were seen in them. Conclusion: Mullerian anomalies were more common in women with PCOS and the most common anomaly was uterine septum. In fact, the present results revealed that it seemed a cause-effect relationship between the mullerian anomalies and PCO syndrome may in fact exist.

Share and Cite:

Moramezi, F. , Barati, M. , Shahbazian, N. , Golbabaei, M. and Hemadi, M. (2013) Sonographic evaluation of mullerian anomalies in women with polycystic ovaries. Health, 5, 1313-1317. doi: 10.4236/health.2013.58178.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Spencer, T.E., Dunlap, K.A. and Filant, J. (2012) Comparative developmental biology of the uterus: Insight into mechanisms and developmental disruption. Molecular and Cellular Endocrinology, 354, 34-53. doi:10.1016/j.mce.2011.09.035
[2] Speroff, L. and Fritz, M.A. (2011) Clinical gynecologic endocrinology and infertility. 8th Edition, Lippincott Williams & Wilkins, 143-148.
[3] Loverro, G., Nappi, L., Vicino, M., Carriero, C., Vimercati, A. and Selvaggi, L. (2001) Uterine cavity assessment in infertile women: Comparison of transvaginalsonography and hysteroscopy. European Journal of Obstetrics & Gynecology and Reproductive Biology, 100, 67-71.
[4] Ludwin, A., Pitynski, K., Ludwin, I., Banas, T. and Knafel, A. (2013) Two and three dimensional ultrasonography and sonohysterography versus hysteroscopy with laparascopy in the differential diagnosis of septate, bicornuate, and arcuate uteri. Journal of Minimally Invasive Gynecology, 20, 90-99. doi:10.1016/j.jmig.2012.09.011
[5] Pui, M. (2004) Imaging diagnosis of congenital uterus malformation. Computerized Medical Imaging and Graphics, 28, 425-433. doi:10.1016/j.compmedimag.2004.05.008
[6] Aubuchon, M., Burney, R.O., Schust, D.J. and Yao, M.W.M. (2007) Infertility and assistant reproduction technology. In: Berek, J., Seigafuse, S. and Berek, N., Gynecology, 14th Edition, Lippincott Williams & Wilkins, 1149-1150.
[7] Pallet, L., Hanna, L., Brincat, M., Galea, R., Brain, H., Whitehead, S. and Mason, H. (2007) Granulosa cell production of anti-mullerian hormone is increased in polycystic ovaries. Journal of Clinical Endocrinology & Metabolism, 92, 240-245.
[8] Cook, C.L., Siow, Y., Brenner, A.G. and Fallat, M.E. (2002) Relationship between serum mullerian-inhibiting substance and other reproductive hormones in untreated women with polycystic ovary syndrome and normal women. Fertility and Sterility, 77, 141-146. doi:10.1016/S0015-0282(01)02944-2
[9] Pigny, P., Jonard, S., Robert, Y. and Dewailley, D. (2006) Serum anti-mullerian hormone as a surrogate for antral follicle count for definition of the polycystic ovary syndrome. Journal of Clinical Endocrinology & Metabolism, 91, 941-945. doi:10.1210/jc.2005-2076
[10] Pigny, P., Merlen, E., Robert, Y., Cortet-Rudelli, C., Decanter, C., Jonard, S. and Dewaily, D. (2003) Elevated serum level of anti-mullerian hormone in patients with polycystic ovary syndrome: Relationship to the ovarian follicle excess and to the follicular arrest. Journal of Clinical Endocrinology & Metabolism, 88, 5957-5962. doi:10.1210/jc.2003-030727
[11] Elder-Geva, T., Margalioth, E.J., Gal, M., Ben-Chetrit, A., Algur, N., Zylber-Haran, E., Brooks, B., Huerta, M. and Spitz, I.M. (2005) Serum anti-mullerian hormone levels during controlled ovarian hyperstimulation in women with polycystic ovaries with and without hyperandrogenism. Human Reproduction, 20, 1814-1819. doi:10.1093/humrep/deh873
[12] Salem, S. (2011) Gynecology. In: Rumak, C.M., Wilson, S.R., Charboneue, J.W. and Levine, D., Eds., Diagnostic Ultrasound, 4th Edition, Elsevier, 580.
[13] Chan, Y.Y., Jayaprakasan, K., Zamora, J., Thornton, J.G., Raine-Fenning N. and Coomarasamy A. (2011) The prevalence of congenital uterine anomalies in unselected and high-risk populations: A systematic review. Human Reproduction Update, 17, 761-771. doi:10.1093/humupd/dmr028
[14] Ugur, M., Karakaya, S., Zorlu, G., Arslan, S., Gulerma,n C., Kukner, S. and Gokmen, O. (1995) Polycystic ovaries in association with mullerian anomalies. European Journal of Obstetrics & Gynecology and Reproductive Biology, 62, 57-59.
[15] Saygili-Yilmaz, E.S., Erman-Akar, D., Yuksel, B. and Yilmaz, Z. (2004) Septate uterus with a double cervix and longitudinal vaginal septum. Journal of Reproductive Medicine, 49, 833-836.
[16] Appelman, Z., Hazan, Y. and Hagay, Z. (2003) High prevalence of mullerian anomalies diagnosed by ultrasound in women with polycystic ovarries. Journal of Reproductive Medicine, 48, 362-364.
[17] Gambineri, A., Pelusi, C., Vicennati, V., Pagotto, U. and Pasquali, R. (2002) Obesity and the polycystic ovary syndrome. International Journal of Obesity and Related Metabolic Disorders, 26, 883-896.
[18] Moran, C., Arriaga, M., Rodriguez, G. and Moran, S. (2012) Obesity differentially affects phenotypes of polycystic ovary syndrome. International Journal of Endocrinology, 2012, 317241. doi:10.1155/2012/317241
[19] McManus, S.S., Levitsky, L.L. and Misra, M. (2013) Polycystic ovary syndrome: Clinical presentation in normalweight compared with overweight adolescents. Endocrine Practice, 19, 471-478. doi:10.4158/EP12235.OR
[20] Sprung, V.S., Jones, H., Pugh, C.J., Aziz, N.F., Daousi, C., Kemp, G.J., Green, D.J., Cable, N.T. and Cuthbertson, D.J. (2013) Endothelial dysfunction in hyperandrogenic polycystic ovary syndrome is not explained by either obesity or ectopic fat deposition. Clinical Science, in press.

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.