Fundal contour of the uterine cavity in the new syndrome of minor müllerian anomalies and oligomenorrhea. A prospective controlled study.

A prospective, controlled, and blinded study was instituted (1) to demonstrate the relationship found previously between mild müllerian anomalies and oligomenorrhea or amenorrhea in another population of infertile or low-fertility women, (2) to substantiate and define the degree of uterine anomaly in patients with this new syndrome, and (3) to demonstrate that fundal anomalies in the patients are not secondary to mechanical trauma. Twenty consecutive patients with oligomenorrhea or amenorrhea, 44 consecutive infertility patients, and 19 patients who underwent hysterosalpingography (HSG) for other reasons made up the study group. A mild uterine developmental anomaly was demonstrated on revision of the HSG films in 50% of the patients with oligomenorrhea or amenorrhea as compared with (1) 25% of the infertility patients with normal menstrual intervals (p less than 0.05) and (2) none of the patients who underwent HSG for other reasons (p less than 0.025). The height (H) of the fundal excavation was less than 10% of the line (L) connecting the peaks of the uterine horns (H/L ratio) on all hysterosalpingograms, which gave rise to doubt whether the uterine contour was normal or abnormal. This applied to five patients with normal whether the uterine contour was normal or abnormal. This applied to five patients with mild müllerian anomalies, the H/L ratio was greater than 0.100 and the mean values for patients with oligomenorrhea and normal intervals were 0.187 and 0.165, respectively (p greater than 0.05). On this basis, it is suggested that the limit between abnormal and normal contour at HSG should perhaps be fixed at an H/L ratio of 0.100. There was no finding in the present study to indicate that the uterine anomalies were secondary to previous curettage, therapeutic abortion, operations on the uterus, or pelvic inflammatory disease.