Many people are confused about the relationship between female genital malformations and fertility. Does having a genital deformity make you not a woman? Can’t have normal children? The answer is neither yes nor no. First of all, let’s understand the normal female reproductive organs. The normal structure of the female reproductive organs is as beautiful as a flower, including: bilateral ovaries (where eggs are produced), bilateral fallopian tubes (where eggs and sperms meet), uterine cavity (where the fetus grows), and the cervix (a protective barrier for the fetus and its appendages in the uterine cavity) …… But when the reproductive organs are malformed, fertility is not so simple, but what are malformations? What to do when malformations occur? Is it possible to get pregnant, maintain the pregnancy and have a successful delivery? In fact, female reproductive tract malformations are divided into three categories: 1. Abnormalities caused by obstruction of normal duct formation, including: vaginal septum, vaginal mediastinum, vaginal atresia, and cervical atresia. 2. Anomalies due to underdevelopment of paramedian duct derivatives, including: absent uterus, absent vagina, unicornuate uterus, etc. 3. Anomalies due to impaired fusion of paramedian duct derivatives, including: double uterus, bicornuate uterus, saddle uterus and mediastinal uterus. How are malformations of the reproductive organs diagnosed? There are a number of tests available, including examination by an obstetrician/gynecologist, ultrasound, iodine oil imaging of the uterine tubes, MRI (magnetic resonance imaging), and hysterosalpingography. The decision on which test to use is made by your doctor after the examination. What are the differences and significance of these tests? A doctor’s examination can detect problems in the vagina and cervix, which can be detected by direct visualization through a speculum. Ultrasound, on the other hand, can show the shape of the uterus, but it is not so precise and is easily disturbed, but it is convenient, inexpensive and non-invasive. The test with relatively high accuracy is uterine tubal iodine oil imaging, which is to take pictures after injecting the contrast agent into the uterine cavity, and the shape of the uterus can be shown more clearly; the advantage is that it can also find out whether the bilateral tubes are open or not at the same time. Nuclear magnetic resonance (MRI) is expensive, but it is very useful in determining malformations of the internal genitalia, with the advantage that it does not require the use of contrast media. Laparoscopy is more intuitive and can be both diagnostic and therapeutic, but it requires anesthesia and is an invasive procedure. Is treatment necessary after the diagnosis has been made? Type I malformations: basic surgery can be performed to remove, open and reconstruct the uterus. Type 2 malformations: no uterus can be removed, no vagina can be surgically resolved by replacing it with intestines or peritoneum; unicornuate uterus cannot be surgically altered, and the risk of miscarriage and uterine rupture increases during pregnancy, so please get pregnant under the guidance of a doctor’s evaluation and monitoring, and regular checkups are required after pregnancy; if there is a combination of stumpy uterus, it will need a doctor’s further examination to see if it needs to be surgically removed. The third type of abnormality: double uterus and saddle uterus usually do not require surgery and you can try to get pregnant. Bicornuate uterus is risky to get pregnant with or without surgery, so you can try to get pregnant, but the rate of complications during pregnancy will increase, and your doctor will need to evaluate whether you need to have a malformed uteroplasty before you get pregnant. And the most numerous and common is the mediastinal uterus, let’s focus on that. The uterus is the equivalent of a room, a warm and spacious room in which your baby happily resides and thrives. A mediastinum uterus, on the other hand, is the equivalent of a wall in the room that divides the room in half, making it half as spacious, and therefore affecting the baby’s growth and development. Surgery is needed to remove the wall and restore a spacious room for the baby to grow.