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Open Access
CC BY 4.0 · Journal of Gastrointestinal and Abdominal Radiology
DOI: 10.1055/s-0045-1811972
Review Article

Müllerian Anomalies: Revisited

Authors

  • Tulika Singh

    1   Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India

  • Gopika Sri

    1   Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India

  • Veenu Singla

    1   Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India

  • Vanita Jain

    2   Department of Obstetrics & Gynecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Abstract

The Müllerian structures are developed from paired embryologic ducts that undergo fusion and resorption in utero to form the uterus, fallopian tubes, cervix, and upper two-thirds of the vagina. Any disruption of the normal embryological development of the Müllerian structure results in Müllerian anomalies. Müllerian anomalies are a complex spectrum of abnormalities that are usually associated with primary amenorrhea, infertility, and obstetric complications. Obstructed anomalies can be associated with endometriosis due to retrograde menstruation and sometimes endometriosis. Frequently, Müllerian anomalies are associated with renal anomalies; therefore, identification of both kidneys is important. Ovaries are normal in patients with Müllerian anomalies. Hysterosalpingography is routinely used in the evaluation of infertility and can demonstrate Müllerian anomalies, but has its limitations in characterizing the external fundal contour, which is a key component in categorizing the Müllerian anomaly. Two-dimensional ultrasound is the first-line modality for evaluating the uterus and adnexa. Three-dimensional ultrasound or magnetic resonance imaging may help to visualize the external uterine fundal contour and internal indentation of the endometrial cavity, which are two morphologic characteristics that are keys to the diagnosis of congenital uterine anomalies. Three-dimensional ultrasound can be used to evaluate uterine morphology and endometrial cavity configuration. The American Society for Reproductive Medicine (ASRM) and European Society of Human Reproduction and Embryology classifications are commonly used to categorize the Müllerian anomaly. The New ASRM classification is more practical as it appears simpler and more user-friendly, as it uses drawings with clear descriptions rather than symbols, and gives us a whole view of the anomaly. Correct diagnosis of Müllerian anomalies and their classification is critical for surgical and clinical management.

Keywords

ASRM classification - infertility - Müllerian anomalies - primary amenorrhea

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Publication History

Article published online:
25 September 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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