Miss Ke, 33 years old, has been experiencing infertility for the past 4 years. She was previously diagnosed with uterine retroversion, and although attempts were made to manually correct the position of the uterus, she still remains unable to conceive. As a result, she has come to the clinic requesting a uterine repositioning surgery.

 

Through vaginal examination and ultrasound examination, it was confirmed that Miss Ke's uterus is retroverted as previously diagnosed. However, during the internal examination, the uterus was found to be freely movable and there were no palpable masses suggestive of endometriosis. Furthermore, she did not exhibit any of the typical 3D symptoms associated with endometriosis, such as menstrual pain, diarrhea during menstruation, or pain during deep intercourse. Faced with these examination results, it is necessary to provide a detailed explanation to the patient in order to address her concerns and clarify the situation.

 

Cases like Miss Ke's still occasionally arise during consultations, and it was even more prevalent among neighbors a decade ago. However, it is crucial to understand that in the current field of reproductive endocrinology, there is no longer any belief that retroversion or anteversion of the uterus can cause infertility. This misconception should no longer be perpetuated. The uterus itself is a flexible organ positioned within the abdominal cavity, and its orientation can vary with different postures. Just like the variability in the position of a man's penis, which can be slightly left, right, or center, the position of the uterus can also differ among individuals. Holding onto the outdated notion that retroverted uterus causes infertility is unfounded.

 

Of course, manually correcting the position of the uterus wouldn't be effective! It is true that severe pathological retroversion can potentially affect fertility, but such cases can be identified through clinical examinations. For example, severe endometriosis, ruptured ovarian chocolate cysts, pelvic inflammation, or peritonitis can cause retroversion of the uterus along with adhesions involving the uterine cul-de-sac and adjacent intestines, resulting in the flexion and fixation of the uterine body. These conditions can be detected during internal examinations and transvaginal ultrasound examinations by carefully maneuvering the probe.

 

If there is a pathological retroversion, it cannot be corrected naturally or manually, and it may potentially affect fertility. However, it is not an absolute factor. Therefore, it is important to undergo other infertility-related examinations in conjunction with a doctor's guidance. If surgery is requested to address uterine retroversion, it should be performed after careful evaluation. In such cases, the surgery is not just about correcting the position of the uterus but primarily focuses on identifying and addressing the underlying pathological conditions causing the retroversion.