Having a retroverted uterus may sound scary, but it’s actually pretty common. In this blog, we discuss what a retroverted uterus is and whether or not it affects your chances of getting pregnant.

What is a retroverted (tilted) uterus?

As the term retroversion suggests, a retroverted uterus, or “tilted uterus,” is a uterus that leans or tilts back toward the spine. A retroverted uterus is a common anatomical variation — approximately one in five women have one.

Having a retroverted uterus does NOT increase a woman’s risk for infertility, endometriosis, or pelvic pain.

One extremely rare complication of having a retroverted uterus is “uterine  incarceration.” This is when a pregnant woman’s growing uterus gets stuck under the sacrum causing pain and trouble urinating. This is estimated to occur in approximately 1 in 3000 to 1 in 10,000 pregnancies. Your obstetrician can correct this complication.

Retroverted Uterus vs. Anteverted Uterus

The uterus can be positioned in one of two ways:

  • Anteverted uterus: An anteverted uterus is a uterus that leans forward at the cervix towards the stomach. Around 70-75% of women have an anteverted uterus.
  • Retroverted uterus: The other 20-25% of women have a retroverted uterus that tilts back toward the spine. A retroverted uterus is also called a tilted, tipped, backward, or retroflexed uterus.

Retroverted Uterus & Fertility

A retroverted uterus does not affect a woman’s ability to get pregnant. It does not impact the ability of the sperm to reach the egg and it doesn’t cause infertility.

retroverted uterus (tilted) comparison diagram

How does a retroverted uterus affect fertility?

The position of the uterus has nothing to do with a woman’s fertility. That said, if another underlying condition causes the retroverted uterus, it may be harder to get pregnant.

Conditions associated with a retroverted uterus include:

  • Endometriosis: Endometriosis is a chronic and inflammatory condition in which tissue similar to the endometrial lining grows outside of the uterus. During the menstrual cycle, the body attempts to break down this tissue. But because it is not inside the uterus, it has nowhere to go. This tissue is trapped within the pelvis and can cause adhesions, scar formation, irritation, and fertility problems.
  • Adenomyosis: Adenomyosis is often called the “evil sister” of endometriosis. It occurs when the endometrial tissue that lines the uterus grows into the muscular walls of the uterus.
  • Uterine fibroids: Uterine fibroids are non-cancerous growths that grow inside the uterus. These growths can cause heavy menstrual bleeding, pelvic pressure and/or pain, and in some cases, infertility.
  • Pelvic inflammatory disease (PID): Pelvic inflammatory disease is an infection of a woman’s reproductive organs. According to the Centers for Disease Control and Prevention (CDC), PID is a complication often caused by sexually transmitted infections (STIs), including chlamydia and gonorrhea.

All of the above conditions are associated with an increased risk of having a retroverted uterus. However, not all women with endometriosis, adenomyosis, fibroids, or a history of PID have a retroverted uterus. The conditions themselves (not their association with uterine position) can cause difficulty conceiving.

What if I have a tipped uterus and infertility?

Tipped uterus or not, anyone struggling with infertility (not being able to get pregnant after one year of unprotected sex) should contact a healthcare professional or fertility specialist. They’ll be able to determine whether or not an underlying condition is causing fertility issues and provide appropriate treatment.

Tilted or Retroverted Uterus: Is It Harder To Get Pregnant? Dr. Susan Treiser Explains

Can you get pregnant with a retroverted uterus?

Yes, it is possible to get pregnant with a retroverted uterus! A retroverted uterus alone will not affect a woman’s ability to get pregnant.

Remember, the goal of the sperm is to reach the uterus and the fallopian tubes. Accomplishing this act depends on the quality of the sperm and cervical and tubal integrity (in addition to other factors like timing and ovulation).

So, if the male partner’s sperm count is good and there are no other issues present (low motility, undescended testicles, etc.), and if the female partner’s cervix is healthy and her fallopian tubes are unobstructed, then pregnancy is possible regardless of the position of the uterus.

How to get pregnant fast with a retroverted uterus

While there is no guaranteed way to get pregnant, there are a few things a woman with a retroverted uterus can do to increase her chances, including:

  • Fertility acupuncture: According to Chinese medicine experts, acupuncture for fertility is a type of acupuncture meant to reduce stress, increase blood flow to the reproductive organs and help balance the endocrine system.
  • Using fertility-friendly lubricants: Some lubricants can deter sperm from reaching the uterus. K-Y Jelly, for example, is one of the least fertility-friendly lubes on the market. Instead, opt for a lube that promotes fertility and keeps sperm safe, alive, and on the move, such as Pre-Seed or ConceivePlus.
  • Tracking ovulation: One of the most important things a woman can do when trying to get pregnant is to have sex during her fertility window, typically about five days before ovulation, plus the day of ovulation and the day after. There are many ways to track ovulation, including using an ovulation prediction kit (OPK), monitoring cervical mucus changes, and tracking basal body temperature (BBT).

Symptoms and Causes of a Retroverted (Tilted) Uterus

For most women, having a retroverted uterus isn’t a cause for concern. However, in some cases, it may result from a pelvic infection, endometriosis, or fibroids. Individuals who are experiencing concerning symptoms, such as painful intercourse, abnormally heavy menstrual bleeding, or difficulty using tampons, should schedule an appointment with their OB-GYN to discuss their concerns.

What causes a retroverted uterus?

Approximately 1 in 5 women are born with a retroverted uterus. Others may develop a retroverted uterus later in life.

Possible causes of a retroverted uterus include:

  • Adhesions or scarring: As mentioned above, scar tissue (whether caused by endometriosis, PID, a cesarean delivery, etc.) can cause the tissues in the pelvis to stick together, which can lead to a retroverted uterus.
  • Fibroids: Uterine fibroids can cause the uterus to change shape and position.
  • Childbirth: During childbirth, a woman’s pelvic floor muscles and ligaments stretch and weaken, which can cause the uterus to tilt in a retroverted position.
  • Menopause: Menopause also causes the pelvic muscles to weaken. When the ligaments can no longer support the uterus, it may begin to tilt backward. For more information on early menopause symptoms and treatments, read our article on Overcoming Early Menopause.

What are the symptoms of a retroverted uterus?

Having a retroverted uterus does not cause any physical symptoms. However, if a woman suffers from another condition (such as endometriosis or PID) that has pushed her uterus into a retroverted position, these conditions themselves may cause symptoms such as pelvic pain and painful intercourse.

Are there any health risks from having a retroverted uterus?

During pregnancy, the uterus should expand and straighten toward the end of the first trimester (between weeks 10 and 12). This shift should lift the uterus out of the pelvis and reposition it, so it is no longer retroverted. Sometimes, however, the uterus cannot make this shift (this could be due to scar tissue or adhesions keeping the uterus in place). If the uterus cannot reposition itself during pregnancy, it can cause a condition called uterine incarceration.

Uterine incarceration, a rare condition in which the uterus becomes trapped in the pelvis, is a serious and potentially devastating complication of pregnancy if it’s not diagnosed and treated promptly.

Pregnant women experiencing one or more symptoms should contact their doctor immediately.

  • incontinence
  • persistent pelvic pain or pain near the rectum
  • constipation
  • the inability to urinate

Approximately one in 3,000 to one in 10,000 pregnancies are affected by uterine incarceration.

Managing and Treating a Retroverted (Tilted) Uterus

Women with a retroverted uterus do not require any treatment or special management.

How is a retroverted uterus diagnosed?

A healthcare professional can diagnose a retroverted uterus during a pelvic exam or during an ultrasound.

So, my tipped uterus is really OK?

In most cases, yes. A retroverted or tilted uterus is a normal variation of the uterus that doesn’t usually cause any problems or require treatment.

When should I see my healthcare provider?

Individuals experiencing one or more of the following symptoms should notify their doctor immediately to rule out any serious medical conditions:

  • abnormally painful menstrual cramps
  • pain with sex
  • heavy menstrual bleeding
  • incontinence
  • pelvic pain or pressure

A Word From RMA Network

Although there is no way to prevent a retroverted uterus, scheduling and keeping regular appointments with your OB-GYN is one way to stay on top of your reproductive health and ensure that any potential issues are caught and treated early.

Additionally, if you’re a woman younger than 35 years old and have been trying to get pregnant unsuccessfully for one year, or a woman 35 or older and have been trying for six months, you should see a fertility doctor.