What is a Bicornuate uterus, and how does that impact reproductive health?

Sometimes in a baby girl’s fetal development there can be a glitch in the development of the uterus.  The uterus and the ovaries originate from different tissues, so the ovaries are unaffected, but the uterus can have a spectrum of abnormalities or differences from the normal single uterine cavity.  Interestingly, the kidneys develop at the same time as the uterus during the embryologic development, so women with a bicornuate uterus or other uterine anomalies should have imaging of the kidneys to confirm that they are normal in structure and location.  The bicornuate uterus has two horns rather than one.  Usually women with a bicornuate uterus don’t know that they have it until there is imaging for something else and then the uterine anomaly is discovered incidentally.  Most women with a bicornuate uterus are able to conceive and have normal fertility.  However, there can be a risk of growth difficulties for her baby in utero because the cavity is not as large, abnormal placental location, or baby having a malpresentation like a breech presentation at term that requires a C-section.  But otherwise no special screening or medical interventions are needed.