Reference values by age
Kelsey et al. (PLoS One, 2016) derived and validated a normative model of uterine volume from birth to age 40 years, using MRI data from healthy young females and data from four transabdominal ultrasound studies of healthy females. Age alone accounted for about 84% of the variation in uterine volume up to age 40.
In this model, uterine volume increases across childhood, with a faster increase in adolescence reflecting the influence of puberty, followed by a slow but progressive rise during adult life.
| Age | 2.5th | 16th | 50th | 84th | 97.5th |
|---|---|---|---|---|---|
| 5 | 0.0 | 0.5 | 1.6 | 3.5 | 6.6 |
| 10 | 0.4 | 1.3 | 3.0 | 5.9 | 10.5 |
| 13 | 7.8 | 13.8 | 24.4 | 42.6 | 72.3 |
| 15 | 15.0 | 25.8 | 44.9 | 77.8 | 131.2 |
| 18 | 16.7 | 28.6 | 49.8 | 86.1 | 145.3 |
| 25 | 20.1 | 34.5 | 59.8 | 103.3 | 174.1 |
| 30 | 23.9 | 40.9 | 70.9 | 122.3 | 206.0 |
| 35 | 26.8 | 45.7 | 79.1 | 136.5 | 229.9 |
| 40 | 27.3 | 46.7 | 81.3 | 140.8 | 238.2 |
Reference centiles are not available beyond age 40 in this model. In a separate ultrasound study of 5,466 non-pregnant uteri without reported abnormal findings (Verguts et al., 2013), mean uterine length increased to 72 mm at age 40 and decreased to 42 mm by age 80, and greater gravidity was associated with larger uterine dimensions.
Centiles are compared using the formula used in the studies pooled by Kelsey (0.5 × L × W × H) on the unrounded volume; the π/6 ellipsoid volume shown is 4.72% higher. Boundary rule (this site's convention; Kelsey does not define one): at or below the 2.5th centile is low, at or above the 97.5th centile is high.
Worked example
A uterus measuring 8.0 × 5.0 × 4.0 cm has a volume of 8.0 × 5.0 × 4.0 × π/6 ≈ 83.78 mL. The Kelsey volume is 80 mL (0.5 × L × W × H). For a 30-year-old, this lies between the 50th (70.9 cm³) and 84th (122.3 cm³) centiles in the Kelsey model.
Frequently asked questions
How is uterine volume calculated?
With the ellipsoid formula: length × width × anteroposterior diameter × π/6 (≈0.5236). For example, 8.0 × 5.0 × 4.0 cm gives about 83.78 mL.
What is a normal uterine volume?
It depends on age. In the Kelsey et al. normative model, the mean (50th centile) uterine volume is 49.8 cm³ at age 18, 70.9 cm³ at age 30 and 81.3 cm³ at age 40.
Does gravidity affect uterine size?
Yes. In an ultrasound study of 5,466 non-pregnant uteri without reported abnormal findings, greater gravidity was associated with greater uterine length, width and anteroposterior diameter.
References
- Kelsey TW, Ginbey E, Chowdhury MM, Bath LE, Anderson RA, Wallace WH. A validated normative model for human uterine volume from birth to age 40 years. PLoS One. 2016;11(6):e0157375. doi:10.1371/journal.pone.0157375. PMID 27295032. PMC4905658.
- Verguts J, Ameye L, Bourne T, Timmerman D. Normative data for uterine size according to age and gravidity and possible role of the classical golden ratio. Ultrasound Obstet Gynecol. 2013;42(6):713-717. doi:10.1002/uog.12538. PMID 23754297.