Some women have cervical agenesis which means that they are born without a cervix. In this case, they may or may not have a uterus and they may or may not have a vagina. If there is cervical agenesis with a uterus present, then the options are: 1. maintain the uterus as it is with suppression of retrograde menses with the utilization of continuous oral contraceptive pill or, 2. a surgical procedure to connect the uterus to a vagina which is either present from birth or has been created. As noted above, (please see “Vaginal Agenesis”), this procedure can be associated with complications. Options for fertility are listed above under “Vaginal Agenesis.”
As noted above, the reproductive tract forms as two tubes which meet in the midline and are intended to fuse. There are cases where fusion does not occur and two cervices can result as with two uteri. This may or may not be associated with a complete vaginal septum (which is described above). A woman with two uteri and two cervices can have a normal reproductive life. She will need a pap smear performed from each cervix, one marked right and one marked left. She does have normal reproductive function, although based on the fact that she has two uteri, each of which is smaller than a normal single uterus, she is at risk for premature labor and also for breech presentation (which means that the baby is coming out feet first) which would most likely necessitate a cesarean delivery.