During most fertility visits, women hear words they never knew existed. One of them is “retroverted uterus” or “retroverted retroflexed uterus.” People do not appreciate how often this really happens and it usually raises such questions as—Is this the reason why I don’t get pregnant? or Do I have to undergo surgery to correct this?
Let’s dissect it in plain, easy-to-understand language and tackle issues regarding retroverted uterus causes, its impact on fertility, and how it is treated.
What Is a Retroverted Uterus?
The uterus is normally slightly tilted towards the bladder. It tilts backward toward the spine in some women. The term used to describe this condition is a retroverted uterus.If the uterus not only tips back but also twists sharply, it’s referred to as a retroverted retroflexed uterus.
It’s worth noting: This is just a variation in the location of the uterus—not always a medical issue. For many women, this is normal and isn’t symptomatic or complicated.
How Common Is It?
About 20–30% of Indian women are estimated to have a retroverted uterus. In most women, they don’t even know it until a pelvic scan or fertility check-up.
In reality, most women with this uterine position have perfectly normal lives, regular periods, and conceive easily.
What is a Cause for a Retroverted Uterus?
Some women are naturally born with a backward-tipping uterus—just anatomical variation. But for others, a cause for a retroverted uterus might be:
Pelvic Inflammatory Disease (PID): Pelvic infections can result in scarring that tugs the uterus back.
Endometriosis: The growth of uterine lining outside the uterus may cause the uterus to be pulled or pushed into a retroverted position.
Fibroids: These non-cancerous tumors within the uterus can alter its shape and cause tilting.
Previous Surgeries: C-section or pelvic surgery can lead to adhesions pulling the uterus back.
Understanding the cause allows fertility specialists to make the correct plan if pregnancy is desired.
Does a Retroverted Uterus Impact Fertility?
This question is among the most commonly posed inquiries. In most cases, a retroverted uterus does not affect fertility. Numerous women with this condition conceive naturally and deliver full-term, healthy babies.
But if a tipped uterus is a symptom of some underlying problem such as endometriosis, fibroids, or PID, those underlying problems can affect fertility. It’s not the tilt, per se, but what is causing it which can be an issue.
Also, in a few instances, the angle can make it a bit more difficult for sperm to travel to the egg, particularly if other issues (such as thick cervical mucus or blocked tubes) are present.
Can a Retroverted Uterus Impact Pregnancy?
Some women with a retroverted uterus experience the following in early pregnancy:
Lower back pain
Painful intercourse
Urinary pressure or incontinence
Typically, by the end of the first trimester, the uterus expands and corrects itself, so naturally, symptoms are alleviated.
In some very rare instances, if the uterus is not correctable by this time and stays retroverted, it can lead to problems such as urinary retention—this necessitates medical attention.
What Are the Symptoms of a Retroverted Uterus?
Most women don’t notice anything out of the ordinary, yet some experience:
Painful menstruation (dysmenorrhea)
Painful intercourse (particularly with deep penetration)
Low back pain
Mild urinary distress (such as)
A sensation of pressure in the pelvic area
If these symptoms are accompanied by fertility issues, it’s best to visit a fertility specialist.
How Is It Diagnosed?
A retroverted uterus is typically diagnosed during:
Pelvic examination
Ultrasound scans
MRI or HSG (if necessary in complicated fertility cases)
A transvaginal scan provides a better insight into uterine position and decides the ideal fertility treatment pathway.
What Are the Treatment Options?
In most instances, there is no treatment needed. But if the uterus is retroverted due to some underlying conditions, then they need to be treated:
For Endometriosis or PID: Medicines or laparoscopy may be recommended.
For Fibroids: Removal through minimally invasive techniques can prove helpful.
Manual Repositioning: In some instances, the uterus may be shifted gently to a forward position.
Pessary Device: This is a silicone pessary placed inside the vagina to assist in maintaining the uterus in a forward direction. It’s not commonly used anymore.
Supporting Fertility: In case of a delayed conception, assisted reproductive methods like IUI or IVF can be evaluated—depending on the overall fertility of both partners.
What to Do If You Have a Retroverted Uterus and Are Planning a Baby?
Don’t worry—it’s not an insurmountable barrier.
Track your cycles accurately and time intercourse around ovulation.
Try positions that facilitate deeper penetration—some believe this helps sperm reach the cervix more easily in a retroverted uterus.
If you’ve been trying for a while without success, consult a fertility specialist to rule out other contributing factors.
A retroverted uterus, even if retroflexed, is not something to worry about or panic over. It’s a normal variation for most women. It only becomes a possible fertility concern when it’s associated with other complications such as endometriosis or pelvic infections.
If you’re having symptoms or planning on getting pregnant and wish to be assured, reach out to a trusted fertility specialist in your area. Current diagnostics and treatments are assisting countless women to overcome fertility challenges every day.
