|Embryology - 2 Apr 2015 Translate|
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- 1 Introduction
- 2 Some Recent Findings
- 3 Paramesonephric Duct
- 4 Duct Molecular Development
- 5 Uterine Development Movie
- 6 Development Overview
- 7 Fetal Uterus
- 8 Fetal Uterus Growth
- 9 Newborn Uterus
- 10 Uterine Tubes
- 11 Uterine Blood Supply
- 12 Uterine Glands
- 13 Uterus Histology
- 14 Abnormalities
- 15 Broad Ligament
- 16 Molecular
- 17 References
- 18 Additional Images
- 19 Terms
- 20 External Links
- 21 Glossary Links
This page introduces the uterus as part of the internal female reproductive tract development. Two paramesonephric ducts form from coelomic epithelium extending beside the mesonephric ducts. In the absence of Mullerian Inhibitory Factor these ducts proliferate and grow extending from the vaginal plate on the wall of the urogenital sinus to lie beside the developing ovary. The paired ducts begin to fuse from the vaginal plate end, forming the primordial body of the uterus and the unfused lateral arms form the uterine tubes. Recent research points to the paramesonephric ducts also being the entire embryonic origin of the vagina.
- Johannes Peter Müller (1801 - 1858) in 1830 was the first to describe the duct historically named after him, the "Müllerian duct". The current terminology is the "paramesonephric duct".
- Genital Links: Introduction | Lecture - Medicine | Lecture - Science | Online Practical | Primordial Germ Cell | Meiosis | Female | Ovary | Oocyte | Uterus | Vagina | Reproductive Cycles | Menstrual Cycle | Male | Testis | Spermatozoa | Prostate | Genital Movies | Abnormalities | Assisted Reproductive Technology | Puberty | Category:Genital
|Historic Embryology - Genital|
|1902 The Uro-Genital System | 1912 Urinogenital Organ Development | 1921 Urogenital Development | 1921 External Genital Development | Historic Disclaimer|
- Menstrual Cycle Links: Introduction | Menstrual Cycle - Histology | Ovary | Oocyte | Uterus | Uterine Gland | Estrous Cycle | Pregnancy Test | Implantation
Some Recent Findings
|More recent papers|
References listed on the rest of the content page and the associated discussion page (listed under the publication year sub-headings) do include some editorial selection based upon both relevance and availability.
Kristýna Němejcová, Sarah L Kenny, Jan Laco, Petr Škapa, Libor Staněk, Michal Zikán, Petra Kleiblová, W Glenn McCluggage, Pavel Dundr Atypical Polypoid Adenomyoma of the Uterus: An Immunohistochemical and Molecular Study of 21 Cases. Am. J. Surg. Pathol.: 2015; PMID: 25828387 Yalei Wang, Chenling Meng, Quanwei Wei, Fangxiong Shi, Dagan Mao Expression and regulation of scavenger receptor class B type 1 in the rat ovary and uterus during the estrous cycle. Acta Histochem.: 2015; PMID: 25817199 Dorota Łukasiewicz, Marlena Chodorowska, Iwona Jakubowska [Obesity as a factor in the development of cancer in type 2 diabetes]. [Otyłość jako czynnik rozwoju nowotworów w cukrzycy typu 2.] Pol. Merkur. Lekarski: 2015, 38(225);135-9 PMID: 25815612 Harith M Alkhateeb, Enas M Yaseen Twin pregnancy in an accessory cavitated non-communicating uterus. Int J Surg Case Rep: 2015, 10;45-48 PMID: 25813124 Diane S Nakamura, Andrew K Edwards, Soo Hyun Ahn, Richard Thomas, Chandrakant Tayade Compatibility of a Novel Thrombospondin-1 Analog with Fertility and Pregnancy in a Xenograft Mouse Model of Endometriosis. PLoS ONE: 2015, 10(3);e0121545 PMID: 25811892
The Müllerian duct (= paramesonephric duct, preferred terminology) paired ducts that form the epithelial lining of female reproductive organs: utererine tube, uterus, upper vaginal canal. The term "paramesonephric" duct means beside the mesonephric (Wolffian) duct, which is its anatomical location in early development. Mullerian refers to Johannes Peter Müller (1801-1858) a German scientist who specialised in comparative anatomy. These ducts initially form and then degenerate in the male.
A recent study using both chicken and mouse embryos has shown that these initially paired tubular structures derive from the coelomic epithelium.
- "Müllerian epithelial tube derived from an epithelial anlage at the mesonephros anterior end, which then segregates from the epithelium and extends caudal of its own accord, via a process involving rapid cell proliferation. This tube is surrounded by mesenchymal cells derived from local delamination of coelomic epithelium."
Mullerian ducts have three elements:
- a canalised epithelial tube
- mesenchymal cells surrounding the tube
- coelomic epithelial cells
Duct Molecular Development
The paired paramesonephic ducts (Müllerian ducts) go through a series of developmental changes recently identified as regulated by a number of molecular factors.
Coelomic epithelium Lim1 expressing cells are specified to a duct fate.
- Lim - proteins named for 'LIN11, ISL1, and MEC3,' are defined by the possession of a highly conserved double zinc finger motif called the LIM domain.
- LIM domain-binding factors - interact with the LIM domains of nuclear proteins are capable of binding to a variety of transcription factors.
Duct invagination induced by Wnt4 to reach the mesonephric (Wolffian)
Cells at the leading tip proliferate and form the duct elongating to reach the cloaca (urogenital sinus). Mesonephric secretes WNT9b to guide duct elongation. Pax2 also acts in elongation and duct maintenance.
- WNT9b - member of the WNT protein family that encode cysteine-rich secreted glycoproteins that act as extracellular signaling factors.
- Pax2 - member of the paired box protein family.
Uterine Development Movie
| Anterior view of development of the female uterus and vagina between Week 9 and 20.
The paramesonephric ducts (red) fuse in the midline to form the genital canal.
The urogenital sinus (yellow), in contact with the paramesonephric duct, thickens to form the sinusal tubercle which extends as a solid vaginal plate, then becomes hollow as the sinovaginal bulb, finally forming the vagina.
|Internal Genital Tract Differentiation|| |
The data below gives an overview of the timecourse of embryonic human uterine development.
- Carnegie stage 18 - Mullerian duct to the coelomic cavity was formed as the result of an invagination of the coelomic epithelium - stage 18
- Carnegie stages 19 - 23 - duct grows independently from the invagination - stage 19
- Week 20 - uterine horn fimbrial development begins and continues after birth - second trimester
Fetal Uterus Growth During this time the uterine circumferunce increases from about 20 mm to just under 60mm and the width increases from less than 10mm to just over 20 mm.
Uterine horn fimbrial development begins after week 20 and continues after birth.
Uterine growth continues postnatally, increasing outer muscle thickness and cyclic changes in the lining with puberty.
Adult external uterine orifice to the fundus is approximately 6.25 cm.
|Growth of the Uterus in the Postfetal Period|
|Age||Length of corpus (mm)||Length of isthmus (mm)||Length of cervix (mm)||Total length (mm)|
|Fetus of 7 months||22|
|Child of 5 weeks||27|
|29 years (nulliparous wife)||34||10||34||78|
|30 years (virgin)||38||7||29||74|
|Data compiled from Hegar (1908) | Uterus Growth Table | Collapsible Table | Uterus Development|
The unfused portion of the paramesonephric ducts will form the uterine tubes. Note that there are several synonyms used for the paired uterine tubes or Fallopian tubes or oviducts or uterine horns.
In the adult, the uterine tube has been described in 4 anatomical regions.
- Infundibulum - funnel-shaped open end of the uterine tube with fimbriae (finger-like extensions), which are closely associated with the ovary. Opens into the peritoneal cavity (abdominal ostium, ostium abdominale)
- Ampulla - uterine tube with highly folded structure with plicae (mucosal folds) and secondary folds dividing the lumen, usual site for fertilization.
- Isthmus - narrow portion of the uterine tube with fewer mucosal folds and a thick muscularis layer.
- Intramural - uterine tube which passes through the muscular wall of the uterus. (an alternative interpretation is that it is an extension of the body of the uterus)
- formed by a ciliated and secretory epithelium resting on a very cellular lamina propria.
- The number of ciliated cells and non-ciliated secretory cells varies along the oviduct.
- Secretory activity varies during the menstrual cycle, and resting secretory cells are also referred to as peg-cells.
- Some of the secreted substances are thought to nourish the oocyte and the very early embryo.
- inner circular muscle layer and an outer longitudinal layer.
- An inner longitudinal layer is present in the isthmus and the intramural part of the oviduct.
- Peristaltic muscle action seems to be more important for the transport of sperm and oocyte than the action of the cilia.
Uterine Blood Supply
Uterine adenogenesis is the term used to describe the formation of uterine glands from the epithelial lining of the uterus. In mammals, this development occurs postnatally and has been described as occurring through a 3 step the sequence:
- differentiation and budding of the glandular epithelium.
- invagination and tubular coiling of the epithelium.
- branching of the glandular elements and their expansion throughout the endometrial stroma toward the myometrium.
Epithelial-mesenchymal interaction occurs through Wnt signalling during this process:
- Wnt7a - expressed in the luminal epithelium
- Wnt5a - expressed in the mesenchyme
See also Menstrual Cycle - Histology
There are at least two clinical society classifications for female genital tract abnormalities:
- American Society for Reproductive Medicine (ASRM) 
- European Society of Human Reproduction and Embryology—European Society for Gynaecological Endoscopy (ESHRE-ESGE)
| A range of uterine and vaginal anatomical anomalies based upon the abnormal development and fusion of the paramesonephric ducts and vaginal plate development.
| Unicornate Uterus - failure of the paramesonephric ducts to fuse. A single paramesomnephric duct has fused with the vaginal plate and now opens into the vagina, while the other forms a diverticulum.
Uterine residual septum classification:
- American Society for Reproductive Medicine (ASRM) criterion with an internal fundal indentation length equal or greater than 1 cm
- European Society of Human Reproduction and Embryology—European Society for Gynaecological Endoscopy (ESHRE-ESGE) classification of female genital tract congenital anomalies with an internal indentation at the fundal midline greater than 50% myometrial thickness.
Septate Uterus Ultrasound
(uterus didelphys, double uterus, uterus didelphis) A rare uterine developmental abnormality where the paramesonephric ducts (Mullerian ducts) completely fail to fuse generating two separate uterus parts each connected to the cervix and having an ovary each.
Mayer-Rokitansky-Kuster-Hauser syndrome (MRKH, MRK anomaly, Rokitansky-Kuster-Hauser syndrome, RKH syndrome, RKH) consists of congenital aplasia of the uterus and the upper part of vagina due to anomalous development of Müllerian ducts, either isolated or associated with other congenital malformations, including renal, skeletal, hearing and heart defects. Has an incidence of approximately 1 in 4500 newborn girls and has been associated with a microdeletion at 17q12.
Cervical: cervical agenesis, cervical duplication
DES Diethylstilbestrol or diethylstilbetrol, is a drug that was prescribed to women from 1938-1971 to prevent miscarriage in high-risk pregnancies. The drug acted as a potent estrogen (mimics natural hormone) and therefore could also act as a potential endocrine disruptor. This led to a number of developing fetal reproductive tract and other abnormalities. In the female fetus, it increased risk of abnormal reproductive tract and also carcinogenic (cancer forming). In the male fetus, it increased the occurance of abnormal genitalia. The drug was banned by FDA (USA) in 1979 as a teratogen, it had previously also been used as livestock growth promoter and could have potentially entered the human food chain. (More? [endocrine2.htm Endocrine Abnormalities] | Abnormal Development - Drugs)
- Links: Endocrine Abnormalities | Abnormal Development - Drugs | Childrens Hospital Boston - Congenital Anomalies of the Uterus | Medical Education Image Link - Cervical agenesis | OMIM - Rokitansky-Kuster-Hauser syndrome |
Wnt genes - Wnt4, Wnt5a, and Wnt7a implicated in the formation and morphogenesis of the M√ºllerian duct.
Wnt7a - mediates the patterning of the oviduct and differentiation of the uterus.
beta-catenin - manufactured in the mesenchyme is a downstream effector of Wnt7a.
Bmp2 - decidualization regulator of gene expression and function (shown in mouse uterus).
Lim1, Lhx9, Emx, Pax-2, Hox-A9, Hox-A10, Hox-A11, Hox-A13, WT1, SF-1, GATA-4. TGF-beta
- Silvana Guioli, Ryohei Sekido, Robin Lovell-Badge The origin of the Mullerian duct in chick and mouse. Dev. Biol.: 2007, 302(2);389-98 PMID: 17070514
- Erica Deutscher, Humphrey Hung-Chang Yao Essential roles of mesenchyme-derived beta-catenin in mouse Müllerian duct morphogenesis. Dev. Biol.: 2007, 307(2);227-36 PMID: 17532316
- Silvana Guioli, Ryohei Sekido, Robin Lovell-Badge The origin of the Mullerian duct in chick and mouse. Dev. Biol.: 2007, 302(2);389-98 PMID: 17070514
- Akio Kobayashi, William Shawlot, Artur Kania, Richard R Behringer Requirement of Lim1 for female reproductive tract development. Development: 2004, 131(3);539-49 PMID: 14695376
- Ryozo Hashimoto Development of the human Müllerian duct in the sexually undifferentiated stage. Anat Rec A Discov Mol Cell Evol Biol: 2003, 272(2);514-9 PMID: 12740945
- Development of the fetal uterus between 19 and 38 weeks of gestation: in-utero ultrasonographic measurements. Soriano D, Lipitz S, Seidman DS, Maymon R, Mashiach S, Achiron R. Hum Reprod. 1999 Jan;14(1):215-8. PMID: 10374123
- Shelton DN, Fornalik H, Neff T, Park SY, Bender D, et al. (2012) The Role of LEF1 in Endometrial Gland Formation and Carcinogenesis. PLoS ONE 7(7): e40312. doi:10.1371/journal.pone.0040312
- Zhen J Wang, Heike Daldrup-Link, Fergus V Coakley, Benjamin M Yeh Ectopic ureter associated with uterine didelphys and obstructed hemivagina: preoperative diagnosis by MRI. Pediatr Radiol: 2010, 40(3);358-60 PMID: 19924410 | PMC2817805
- The American Fertility Society classifications of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies, müllerian anomalies and intrauterine adhesions. Fertil. Steril.: 1988, 49(6);944-55 PMID: 3371491
- Grigoris F Grimbizis, Stephan Gordts, Attilio Di Spiezio Sardo, Sara Brucker, Carlo De Angelis, Marco Gergolet, Tin-Chiu Li, Vasilios Tanos, Hans Brölmann, Luca Gianaroli, Rudi Campo The ESHRE-ESGE consensus on the classification of female genital tract congenital anomalies. Gynecol Surg: 2013, 10(3);199-212 PMID: 23894234
- C Bermejo, P Martínez Ten, R Cantarero, D Diaz, J Pérez Pedregosa, E Barrón, E Labrador, L Ruiz López Three-dimensional ultrasound in the diagnosis of Müllerian duct anomalies and concordance with magnetic resonance imaging. Ultrasound Obstet Gynecol: 2010, 35(5);593-601 PMID: 20052665
- A Ludwin, I Ludwin, K Pityński, T Banas, R Jach Role of morphologic characteristics of the uterine septum in the prediction and prevention of abnormal healing outcomes after hysteroscopic metroplasty. Hum. Reprod.: 2014, 29(7);1420-31 PMID: 24838703 | Hum Reprod.
- Recurrent microdeletion at 17q12 as a cause of Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome: two case reports. Bernardini L, Gimelli S, Gervasini C, Carella M, Baban A, Frontino G, Barbano G, Divizia MT, Fedele L, Novelli A, Béna F, Lalatta F, Miozzo M, Dallapiccola B. Orphanet J Rare Dis. 2009 Nov 4;4:25. PMID: 19889212
- Lifetime changes in the vulva and vagina. Farage M, Maibach H. Arch Gynecol Obstet. 2006 Jan;273(4):195-202. PMID: 16208476
- Function of sexual glands and mechanism of sex differentiation. Kavlock R, Cummings AJ Toxicol Sci. 2004 Aug;29(3):167-78. Review. PMID: 15467266 | See Related Articles
- Essential roles of mesenchyme-derived beta-catenin in mouse Mullerian duct morphogenesis. Deutscher E, Hung-Chang Yao H. Dev Biol. 2007 May 3; PMID: 17532316
- Guioli S, Sekido R, Lovell-Badge R. The origin of the Mullerian duct in chick and mouse. Dev Biol. 2007 Feb 15;302(2):389-98.
- Hashimoto R. Development of the human Mullerian duct in the sexually undifferentiated stage. Anat Rec A Discov Mol Cell Evol Biol. 2003 Jun;272(2):514-9.
Search May 2007 "embryonic uterine development" 3,025 reference articles of which 491 were reviews.
Note some of these terms relate to the adult or the maternal uterus during pregnancy.
- cervical cerclage - A clinical birth procedure involving circumferential banding or suture of the cervix early (between 12 -14 weeks) or when required to prevent or treat passive dilation prior to completion of pregnancy (37 weeks), described as cervical insufficiency.
- cervical insufficiency - (CI) A clinical term describing a painless and progressive dilatation and effacement of the cervix that may lead to second trimester abortions or preterm delivery. It has also been described as inability of the uterine cervix to retain a pregnancy in the absence of uterine contractions. The condition may in some instances treated clinically by cervical cerclage. The biological basis is currently undetermined with some evidence showing a genetic relationship.
- cervical length - There is some data that shows the risk of spontaneous preterm labour and delivery increases in women who have a short cervix PMID 8569824.
- cervical mucus plug - (CMP) During early pregnancy, maternal glands located at the cervical junction between vagina and uterus secrete mucus that forms a plug or barrier between these two structures.
- cervical pregnancy - A rare type of ectopic pregnancy with implantation at the cervical canal, occurring with an incidence ranging between 1:1,000 and 1:18,000 pregnancies. Clinically, when an associated haemorrhage occurs a hysterectomy is usually performed.
- cervical ripening - Clinical birth term describing the hormonal softening of the cervix to allow expansion in preparation for birth.
- cervix - (Latin, cervix = neck) The female anatomical region of the uterus forming a canal that opens and connects to the vagina.
- fundus - (Latin, fundus = "bottom") Top part of the uterus body lying between the two uterine tubes and a common implantation site.
- hysterosalpingography - A clinical diagnostic technique used to visualise the uterine cavity by X-ray.
- hysteroscopy - A clinical diagnostic technique used to visualise the uterine cavity by a camera or video.
- Pouch of Douglas - (rectouterine pouch or rectovaginal) Anatomical description of the female peritoneal cavity lying between the back wall of the uterus and rectum.
- rectouterine pouch - (Pouch of Douglas or rectovaginal) Anatomical description of the female peritoneal cavity lying between the back wall of the uterus and rectum.
- sonohysterography - A clinical diagnostic technique used to visualise the uterine cavity by ultrasound. Firstly, fluid is injected through the cervix into the uterus, then ultrasound is carried out to image the uterine cavity.
External Links Notice - The dynamic nature of the internet may mean that some of these listed links may no longer function. If the link no longer works search the web with the link text or name.
- Blue Histology Female Reproductive Tract
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Cite this page: Hill, M.A. (2015) Embryology Uterus Development. Retrieved April 2, 2015, from https://embryology.med.unsw.edu.au/embryology/index.php/Uterus_Development
- © Dr Mark Hill 2015, UNSW Embryology ISBN: 978 0 7334 2609 4 - UNSW CRICOS Provider Code No. 00098G