@misc{10481/98616,
year = {2025},
month = {1},
url = {https://hdl.handle.net/10481/98616},
abstract = {Background A didelphic uterus represents a unique and infrequent congenital condition in which a woman
possesses two distinct uteri, each with its own cervix. This anomaly arises due to partial or incomplete merging of the
Müllerian ducts during the developmental stages in the womb. Accounting for uterine malformations, a didelphic
uterus is a relatively rare condition, affecting approximately 0.5–2% of the population and is considered one of the
more uncommon types of uterine abnormalities.
Methods This case report aims to study the physical separation in uterine didelphys and its impact on endometrial
microbiome and inflammation, and the patterns of endometrial receptivity observed.
Results Endometrial receptivity analyses revealed a similar receptive state in both uteri, both in the early receptive
phase. Differential markers of chronic endometritis, including CD138, and MUM1-positive cells, were observed
when comparing endometrial biopsies from both uteri. The right uterus exhibited a higher prevalence of these
positive cells. Regarding the microbiome, significant differences were found between the uteri, notably in the right
uterus, a clear non-dominance of lactobacilli and the presence of genera such as Staphylococcus, Streptococcus,
and Acinetobacter. Additionally, the right uterus presented a less ‘favourable’ microenvironment, a characteristic
that was also reflected in the right cervix; both sites presenting less lactobacilli than the left side samples. A distinct
metabolomic signature associated with the physical separation of the uteri contributed to the differences in
endometrial milieu.
Conclusions Our study revealed that physical separation, among other factors in uterus didelphys, affects the
endometrial microbiome, metabolome, and inflammatory state, with significant microbiome variation observed
between the uteri, although similar endometrial receptivity patterns were noted.},
organization = {Projects Endo-Map PID2021-12728OB-I00, ROSY
CNS2022-135999 funded by MICIU/AEI/10.13039/501100011033 and by
FEDER, EU, and Enterprise Estonia (grant EU48695 and project RE.5.02.22–019
ReadUteru)},
organization = {Becas Fundación Ramón Areces para
Estudios Postdoctorales – Convocatorias XXXV and XXXVI, respectively, para
Ampliación de Estudios en el Extranjero en Ciencias de la Vida y de la Materia},
organization = {Plan de Recuperación, Transformación y resiliencia, Ayudas
para la recualificación del sistema universitario español, Ayudas Margarita Salas para la formación de jóvenes doctores – Universidad de Murcia},
organization = {Horizon Europe (NESTOR, grant no. 101120075) of the European
Commission and the Estonian Research Council (grant no. PRG1076)},
publisher = {BioMed Central},
keywords = {Uterus didelphys},
keywords = {Microbiome},
keywords = {Metabolome},
title = {Uterus didelphys: the first case report on molecular profiling of endometrial tissue from both uterine cavities},
doi = {10.1186/s12958-024-01330-7},
author = {Sola Leyva, Alberto and Romero, Barbara and Canha-Gouveia, Analuce and Pérez Prieto, Inmaculada and Molina, Nerea M. and Vargas Liébanas, Eva and Mozas Moreno, Juan and Chamorro Santos, Clara and Saare, Merli and Salumets, Andres and Altmäe, Signe},
}