Will a Tilted Uterus Make Conception Difficult?

At my last pap smear, the doctor was having a difficult time getting a sample because I have a very tilted uterus. When I asked if it would be difficult for me to conceive, he said yes. When I asked my regular physician, he said no. I am almost 40 and worried. Which doctor is right?

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Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

Uteri may normally be directed upward toward the abdominal wall (anteverted) or backwards toward the rectum (retroverted). Some are midline. When the uterus is retroverted, the cervix tends to be directed upward toward the pubic bone; however, this is not true in all cases.

After intercourse, the pool of semen would not be in direct contact with your cervix if it is directed upward. In women with other fertility issues, this can matter. In the majority of women, however, this may have no significance. The sperm find their way into the uterus within a few seconds of ejaculation and they swim great distances to get there!

Around 40, however, your fertility has started to decline. This added issue may decrease your chances of conception. If you hope to become pregnant, I would follow the guidance in Toni Weschler's book "Taking Charge of Your Fertility." You will want to start observing signs of fertility, cervical mucus changes, cervical position and consistency as well as basal body temperatures.

Having sex with the woman on top may keep the semen pool in contact with your cervix. Lying on your abdomen after sex may help as well. With ejaculation, your partner could withdraw about halfway, as this might place the semen in the optimal position.

Most women have no problems getting pregnant with a retroverted uterus. But if six months goes by without conception, it would be a good idea to get Toni's book and follow her recommendations. If after six more months, you do not conceive, it is time to seek the assistance of a reproductive endocrinologist.

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