Lying Prone Does Not Help Conception in Women with Retroverted Uterus
There is no evidence that lying in a prone position improves conception rates in women with a retroverted uterus, and this practice should not be recommended.
Understanding Retroverted Uterus and Fertility
A retroverted uterus occurs in approximately 15-20% of women and is generally not a cause for concern regarding fertility 1. The uterus position itself does not create a mechanical barrier to conception, as sperm reach the fallopian tubes within 5-10 minutes after intercourse regardless of uterine position 2.
Evidence on Post-Coital Positioning
The only relevant positioning data comes from intrauterine insemination (IUI) studies, which examined supine (lying on back) positioning—not prone positioning:
- Supine immobilization for 10-15 minutes after IUI showed conflicting results in high-quality trials 2
- The most recent large RCT (498 patients) found no significant difference in pregnancy rates between immediate mobilization versus 15 minutes of supine rest (RR = 0.81,95% CI: 0.63-1.02) 2
- When pooled with earlier studies, the overall effect was neutral (OR = 1.00,95% CI: 0.74-1.33) with substantial heterogeneity 2
Why Prone Position Is Not Recommended
- No physiologic rationale: Sperm transport to the fallopian tubes occurs rapidly (5-10 minutes) and is independent of body position 2
- No supporting evidence: There are no studies examining prone positioning for conception in any population, including women with retroverted uteri
- Pregnancy considerations: Once pregnant (after 20 weeks gestation), the prone position becomes impractical, and pregnant women should actually avoid supine positioning due to aortocaval compression 2, 3
Clinical Implications of Retroverted Uterus
While a retroverted uterus may be associated with slightly higher rates of IVF use (12.3% vs 6.8% in anteverted uteri), this does not translate to recommendations for specific positioning 1. The retroverted position:
- Does not increase pregnancy complications once conceived 1
- Does not affect delivery outcomes 1
- Usually corrects to an anteverted position spontaneously by 14 weeks gestation 4, 5
What Actually Matters for Conception
Rather than focusing on unproven positioning techniques, women with retroverted uteri and fertility concerns should pursue evidence-based interventions such as ovulation tracking, addressing any underlying fertility factors, or considering assisted reproductive technologies if indicated 1.