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ESHRE/ESGE Classification of Uterine Anomalies

European Society of Human Reproduction and Embryology (ESHRE) and the European Society for Gynaecological Endoscopy (ESGE)

Uterine anatomy is the basis of the new system. Embryological origin has been adopted as the secondary basic characteristic in the design of the main classes. Cervical and vaginal anomalies are classified in independent co-existent sub-classes.


  • Class U0 - incorporates all cases with normal uterus.
  • Class U1 - (Dysmorphic uterus) incorporates all cases with normal uterine outline but with an abnormal shape of the uterine cavity excluding septa. Class I is further subdivided into three categories
    • Class U1a - (T-shaped uterus) characterized by a narrow uterine cavity due to thickened lateral walls with a correlation 2/3 uterine corpus and 1/3 cervix,
    • Class U1b - (uterus infantilis) characterized also by a narrow uterine cavity without lateral wall thickening and an inverse correlation of 1/3 uterine body and 2/3 cervix
    • Class U1c - (others) which is added to include all minor deformities of the uterine cavity including those with an inner indentation at the fundal midline level of less than 50 % of the uterine wall thickness.
  • Class U2 - (septate uterus) internal indentation >50 % of the uterine wall thickness & external contour straight or with indentation <50 %
    • Class U2a - (partial septate uterus) characterized by the existence of a septum dividing partly the uterine cavity above the level of the internal cervical os
    • Class U2b - (complete septate uterus) characterized by the existence of a septum fully dividing the uterine cavity up to the level of the internal cervical os.
  • Class U3 - (bicorporeal uterus) external indentation >50 % of the uterine wall thickness
    • Class U3a - (partial bicorporeal uterus) characterized by an external fundal indentation partly dividing the uterine corpus above the level of the cervix
    • Class U3b - (complete bicorporeal uterus) width of the fundal indentation at the midline >150 % of the uterine wall thickness) completely dividing the uterine corpus up to the level of the cervix
    • Class U3c - (bicorporeal septate uterus) characterized by the presence of an absorption defect in addition to the main fusion defect.
  • Class U4 - (hemi-uterus) incorporates all cases of unilateral formed uterus. Hemi-uterus is defined as the unilateral uterine development; the contralateral part could be either incompletely formed or absent.
    • Class U4a - (hemi-uterus with a rudimentary (functional) cavity) characterized by the presence of a communicating or non-communicating functional contralateral horn
    • Class U4b - (hemi-uterus without rudimentary (functional) cavity) characterized either by the presence of non-functional contralateral uterine horn or by aplasia of the contralateral part.
  • Class U5 - (aplastic uterus) incorporates all cases of uterine aplasia, formation defect characterized by the absence of any fully or unilaterally developed uterine cavity.
    • Class U5a - (aplastic uterus with rudimentary (functional) cavity) characterized by the presence of bi- or unilateral functional horn
    • Class U5b - (aplastic uterus without rudimentary (functional) cavity) characterized either by the presence of uterine remnants or by full uterine aplasia.
  • Class U6 - is kept for still unclassified cases.


Links: Genital System - Abnormalities | Uterus Development | simplified cartoon

Reference

Grimbizis GF, Gordts S, Di Spiezio Sardo A, Brucker S, De Angelis C, Gergolet M, Li TC, Tanos V, Brölmann H, Gianaroli L & Campo R. (2013). The ESHRE-ESGE consensus on the classification of female genital tract congenital anomalies. Gynecol Surg , 10, 199-212. PMID: 23894234 DOI.

Copyright

The Author(s) 2013. This article is published with open access at Springerlink.com

This manuscript was published simultaneously in the journals of Human Reproduction and Gynecological Surgery.


Cite this page: Hill, M.A. (2024, June 17) Embryology Uterine anomalies ESHRE-ESGE classification.jpg. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/File:Uterine_anomalies_ESHRE-ESGE_classification.jpg

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© Dr Mark Hill 2024, UNSW Embryology ISBN: 978 0 7334 2609 4 - UNSW CRICOS Provider Code No. 00098G

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