Is it true that women with a tilted uterus will have trouble getting pregnant? My husband and I have been trying to get pregnant for nearly two years. We tried IUI, but it failed. His sperm count is 17 million, and his doctor hasn't prescribed anything to get it up. My doctor checked my tubes and they are OK.

Lisa

A tilted uterus is no cause for concern. The uterus is has two portions. The lower portion, or cervix, protrudes into the vagina. The upper portion (approximately two-thirds of the uterus), called the uterine fundus, is the site of embryo implantation. The cervix is thin and narrow, and the uterine fundus is wider; picture an upside-down pear.

At the point where the cervix joins the uterine fundus -- called the cervico-uterine junction -- the uterus can bend. This means the uterus can be tipped forward (anteriorly), so its top points toward your abdominal wall. Or it can be tipped backwards (posteriorly), pointing toward your back; this is called a retroverted uterus. In about 80 percent of women, the uterus is anteflexed (in the forward position).

We don't know what causes the uterus to tip one way or the other. There is no correlation between the direction of tip and fertility. So, I would not be concerned about a retroverted uterus. If you and your husband have fertility problems, a careful, comprehensive evaluation is in order.