Yannick Hurni: What Is a ‘Normal Uterus’? From Morphology to Function
Yannick Hurni, Junior mentor of PPCR 2026 at Harvard T.H. Chan School of Public Health, shared a post on LinkedIn:
“Paper of the Week 11 — What is a ‘normal uterus’? The endless debate
What do we really mean when we say ‘normal’?
The recent NURSE study (January 2026) sets an impressive milestone: a large, multicentric cohort providing, for the first time, objective morphometric reference values for the uterus in presumed healthy nulliparous women.
The strength of this work lies in its numbers, its rigor, and its methodology. Not because it immediately changes clinical practice, but because it builds something even more important: a solid, reproducible foundation on which future research can stand.
And yet… the story doesn’t end there.
In the April issue of Fertility and Sterility, the discussion takes an interesting turn. Christian Battipaglia and Antonio LA MARCA challenge the very concept of ‘normality’, reminding us that statistical normal ≠ biological normal.
They propose a shift in perspective: should we define normality based on morphology alone, or should we instead look at functional normality, i.e., the ability to reproduce?
This is where the debate becomes truly fascinating.
The authors of the NURSE study (Marco Gergolet, Pierpaolo Nicolì, Amerigo Vitagliano) respond with remarkable scientific clarity and methodological rigor.
Their position is equally compelling:
- First, define morphology objectively.
- Then, build correlations with function.
Because without a solid baseline, any functional interpretation risks becoming inconsistent, or worse, biased.
This is exactly the kind of debate we need to keep alive.
We must start from robust, shared, scientific definitions, but we cannot stop there. The next step is inevitable: moving toward functional and outcome-based frameworks, which may eventually reshape our classifications into tools that are truly meaningful both clinically and for research.
Morphometry first… but function must follow.
Have you read these papers?
If not, I strongly recommend going back to the NURSE study and then diving into this passionate exchange.
I’m curious to hear your thoughts. Where do you stand in this debate?”
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