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    Few women have ever given more than a couple of seconds’ thought about their uterus. That is, of course, until they start trying to conceive. Statistically, about one in five women will discover that they have a retroverted uterus. Sometimes, women become so overwhelmed with this news that rather than asking further questions, they simply surrender the idea of ever getting pregnant. If you happen to be that one in five with a retroverted uterus, rest assured that not all hope is lost. With the proper help of an informed and skilled physician, you can successfully conceive and carry to full term. 

    Retroversion of the uterus is a backwards tilt of the uterus so that it points towards the spine, instead of the more common orientation of pointing slightly forward, toward the belly. However, it is far from being a disease. Dr. Dora Barrion-Dimarucut, MD, FPOGS, from the Medical Center Imus, Cavite states, “Retroversion, in fact, accounts for about 20% of uterine orientation, and is not considered abnormal.” If a woman’s uterus is naturally tilted backwards, it’s essentially like being born left-handed instead of right-handed - despite using a different hand, you are still perfectly capable of writing. Occasionally, the uterus can become retroverted due to scarring from endometriosis, fibroids, or other previous infections. If this is the case, then it’s important to treat the causes of the retroversion first.

    According to Dr. Dimarucut, if it is the result of an organic cause like endometriosis, it may make chances of pregnancy more difficult, not because of retroversion itself, but because of the endometriosis causing changes in the normal reproductive anatomy, hampering sperm and egg transport. In terms of ability to conceive, Dr. Dimarucut points out, “The chances of conceiving are about the same as a [normal] anteverted uterus, on the premise that there are no other organic causes of the retroversion.

    During sexual intercourse, especially as the female reaches orgasm, the cervix and its canal straighten to accommodate and facilitate easier entry of the sperm. So, even with retroversion, conception is very possible. A change in the tilt is significant only if, even during intercourse, the cervical canal does not straighten to accommodate the sperm, or makes it impossible for the sperm to enter.” 

    Is there a sexual position that will help facilitate things? The verdict is still out: despite numerous anecdotes, nothing has been scientifically validated.

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    As for the course of pregnancy and the risks of complications, it is essentially the same as with a woman who has a “normal” uterus. Dr. Dimarucut adds, “Occasionally, a woman with a retroverted uterus might complain of urinary retention in the early part of pregnancy, as it may put pressure on the bladder.

    However, as the pregnancy enters the second trimester, and the uterus gets out of the pelvis, then the symptom disappears.” Other doctors further report that after the first pregnancy, a retroverted uterus often assumes the more common orientation of tilting forward. The best part of all? Delivery won’t be made worse by a retroverted uterus.

    For many, the ability to bear children is the ultimate expression of womanhood, yet so often, dreams of starting a family have been unnecessarily shattered due to mere disinformation or willful ignorance. Dr. Dimarucut, despite having a retroverted uterus herself, had no problems conceiving nor carrying to full term. To date, she has three children. “Being in the medical field, I was not at all worried about my retroversion.” She advises that women keen on conceiving should try to educate themselves or seek the help of a professional primarily for counseling.  She notes, “It is not advisable to believe all that is written or stated on the Internet. Check your sources. The best person to ask would still be your obstetrician. Do not hesitate to voice out all your concerns.” 

    Like most informed obstetricians and gynecologists, Dr. Dimarucut believes that pregnancy planning is key. Have your physician review your health history, and do a thorough evaluation to assess risk factors for pregnancy, if any. In addition, ask which dietary and lifestyle changes should be done well before trying to get pregnant, and which ones to do during pregnancy. For instance, Dr. Dimarucut recommends taking Folic Acid BEFORE pregnancy rather than during, in order to best prevent neural tube defects in the embryo.

    As someone who’s “been there, done that, bought the T-shirt”, Dr. Dimarucut is confident that a retroverted uterus alone is not reason enough to lose hope of ever conceiving. “Retroversion can be easily diagnosed by internal examination or ultrasound. If it is not related to other conditions, then there's pretty much nothing to worry about.” 

    She advises women to not be alarmed if conception doesn’t occur immediately, and instead seek help only if they’re unable to conceive after one year of regular, unprotected sex. Finally, even if fertility tests reveal less than ideal outcomes, there are reproductive endocrinologists and infertility specialists who can discuss more options to conceive. The road may be long, but will certainly be worth the wait.

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