Jan. 7, 2009 -- London resident Lindsay Hasaj assumed she was a pretty ordinary person for the first 27 years of her life. She had a nice job in financial sales, got married in July and two months later became pregnant.
But within weeks of the news, Hasaj went to the hospital with abdominal pain. Soon after, doctors discovered she had two sets of reproductive organs; two vaginas, two cervixes and two wombs.
"It was one of the awful cases of being in the room with the sonographer and they're being quiet and evading your questions," said Hasaj. "Then they get up and say: 'Sorry I have to see one of my superiors.'"
Hasaj said she was left lying on the examination table in a panic, at most imagining an ectopic pregnancy. Minutes later the superior came in to look and said quite matter-of-factly, "Oh, by the way you have two wombs and two cervixes," Hasaj said.
"Oh, my husband was absolutely devastated. His first concern was for my health," said Hasaj of her husband, Tony Hasaj. "But this is our first child and it's very much a longed-for child, so we are both walking on eggshells at the moment."
Doctors told Hasaj that she was really very lucky to have conceived so easily and that the baby seemed fine. The pain, it turned out, was only a coincidence and caused by a common ovarian cyst.
"Everything was on the right side, the baby's in the womb on the right side, the cyst was on the ovary on the right side," said Hasaj.
But after that strange announcement came the news that the pregnancy would be high risk. Hasaj's doctor, who was unavailable for an interview, estimated in news reports that she had a 60 percent to 65 percent chance of having a healthy baby at the end of a full-term pregnancy.
Studies of womb malformations estimate that one in 3,000 women have Hasaj's condition of uterus didelphys, according to Dr. Ed Huang, associate director of the OB/GYN Residency Program at Massachusetts General Hospital in Boston.
However, in Huang's experience, a double uterus is much rarer. In 14 years of experience as a doctor, caring for 30,000 women, Huang said he has only seen four cases like Hasaj's.
A Lucky Pregnancy With High Risks
"Most of these women end up having a [Caesarean] section," he said, explaining that Hasaj's condition likely happened during a developmental stage in the womb.
Normally, two long tube organs that become the fallopian tubes fuse together at the bottom to create a vagina, cervix and womb. But in Hasaj's case the fusion never occurred. She now has two halves of a full uterus; each of Hasaj's wombs is smaller than a normal womb.
"That increases the risk that the uterus might not be able to stretch to hold a full pregnancy," said Huang.
Indeed, Hasaj has been told she faces increased risks for premature birth, a breech baby and miscarriage.
"My cervix has to be measured every two weeks," said Hasaj, who noted her biggest worry for now will be whether her cervix starts to dilate early.
A Life-Changing Pregnancy
With a written letter from her doctor, Hasaj has left work during her pregnancy to reduce stress and stress hormones known to increase the risk of early labor.
"Where for most women the risk of miscarriage drops off after 12 weeks, there's always a risk for me," she said.
Hasaj considers herself lucky, but she and husband Tony aren't picking out names yet.
"We're trying not to get our hopes up too full," she said.
However, experts such as Dr. Richard J. Paulson, chief of reproductive endocrinology and infertility at the University of Southern California Keck School of Medicine in Los Angeles, have some encouraging words.
"Prior to the days of ultrasound most of these cases were discovered at the time of Caesarean," said Paulson, who has seen other cases of Hasaj's condition.
Paulson said reproductive malformations ranging from a complete failure of the two tubes to fuse as in Hasaj's case, to an oddly heart-shaped uterus are relatively common.
"It would be a rare case if she got pregnant in both uteri at the same time," he said.
Paulson also wasn't at all surprised to hear that Hasaj never guessed she had two vaginas or cervixes.
"I don't want you to imagine that she looks any different on the outside," he said. "In regular life, you're unaware of the anatomy beyond the first couple of centimeters."
A Difficult Discovery
In pelvic exams, during intercourse or any other normal situation, Paulson said it's difficult to feel that a person has two vaginas. Paulson used an analogy of walking into a tent separated by a tarp down the middle with your eyes closed.
"Once inside, you can't feel a difference in the wall," said Paulson. "A vast majority of the time these things aren't discovered, even in an exam."
The same was true for Hasaj, who said she'd gotten regular annual checkups since she was 18. This new discovery finally explains why every other pap smear gave inconclusive results.
"For the last nine years, I've had so many smears -- possibly 30 different people have given me smear tests," said Hasaj. "The doctors said only thing you would have noticed would be you had problems using tampons."
When she heard that, Hasaj said her history made perfect sense.
"I thought 'oh my god, yes," said Hasaj, who thought something was strange during the previous periods.
"But I never would have guessed this," she said.