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Mullerian dysgenesis: a critical review of the literature

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Abstract

Purpose

To present an update of the genetic, clinical, diagnostic, and therapeutic aspects of Mayer–Rokitansky–Kuster–Hauser (MRKH) syndrome.

Methods

Studies were considered eligible if they have evaluated patients with MRKH syndrome. Eligible articles were identified by a search of MEDLINE bibliographical database from 1950 to August 2016. A purely descriptive approach was adopted concerning all outcomes examined by the individual studies.

Results

MRKH syndrome is defined as congenital aplasia of the upper vagina and impairment of uterine development in normal 46XX females. Accounting for 1:4500 women, MRKH is the second most common cause of primary amenorrhea following gonadal dysgenesis. Potential association of MRKH syndrome to specific genes has been the focus of recent research. Null-association results of HOXA genes and Wnt5a, Wnt7a, and Wnt9a have been reported, while point mutations of the WNT4 gene point mutations have been associated with an MRKH-like syndrome characterized by Mullerian duct regression and hyperandrogenism. Ultrasound and Magnetic Resonance Imaging (MRI) are the main techniques to establish an accurate diagnosis of the syndrome. Several non-surgical and surgical procedures have been reported for the creation of a functional neovagina; in general, non-surgical treatment should be the first initially pursued. Along with psychological support, recent developments in assisted reproductive technologies of IVF techniques and the availability of gestational surrogacy, as well as the recent breakthrough of successful uterus transplantation, enable women with MRKH syndrome to attain their own genetic child.

Conclusion(s)

MRKH syndrome is a medical modality with important social, legal, and ethical projections that require a multi-disciplinary approach.

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References

  1. D’Alberton A, Reschini E, Ferrari N, Candiani P (1981) Prevalence of urinary tract abnormalities in a large series of patients with uterovaginal atresia. J Urol 126(5):623–624

    PubMed  Google Scholar 

  2. Chawla S, Bery K, Indra KJ (1966) Abnormalities of urinary tract and skeleton associated with congenital absence of vagina. Br Med J 1(5500):1398–1400

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Willemsen WN (1982) Renal–skeletal–ear- and facial-anomalies in combination with the Mayer–Rokitansky–Kuster (MRK) syndrome. Eur J Obstet Gynecol Reprod Biol 14(2):121–130

    Article  CAS  PubMed  Google Scholar 

  4. Oppelt P, Renner SP, Kellermann A, Brucker S, Hauser GA, Ludwig KS et al (2006) Clinical aspects of Mayer-Rokitansky-Kuester-Hauser syndrome: recommendations for clinical diagnosis and staging. Hum Reprod 21(3):792–797

    Article  PubMed  Google Scholar 

  5. Fedele L, Bianchi S, Tozzi L, Borruto F, Vignali M (1996) A new laparoscopic procedure for creation of a neovagina in Mayer-Rokitansky-Kuster-Hauser syndrome. Fertil Steril 66(5):854–857

    Article  CAS  PubMed  Google Scholar 

  6. Carson SA, Simpson JL, Malinak LR, Elias S, Gerbie AB, Buttram VC Jr et al (1983) Heritable aspects of uterine anomalies. II. Genetic analysis of Mullerian aplasia. Fertil Steril 40(1):86–90

    Article  CAS  PubMed  Google Scholar 

  7. Tiker F, Yildirim SV, Barutcu O, Bagis T (2000) Familial mullerian agenesis. Turk J Pediatr 42(4):322–324

    CAS  PubMed  Google Scholar 

  8. Griffin JE, Edwards C, Madden JD, Harrod MJ, Wilson JD (1976) Congenital absence of the vagina. The Mayer-Rokitansky-Kuster-Hauser syndrome. Ann Intern Med 85(2):224–236

    Article  CAS  PubMed  Google Scholar 

  9. Strubbe EH, Cremers CW, Willemsen WN, Rolland R, Thijn CJ (1994) The Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome without and with associated features: two separate entities? Clin Dysmorphol 3(3):192–199

    CAS  PubMed  Google Scholar 

  10. Duncan PA, Shapiro LR, Stangel JJ, Klein RM, Addonizio JC (1979) The MURCS association: mullerian duct aplasia, renal aplasia, and cervicothoracic somite dysplasia. J Pediatr 95(3):399–402

    Article  CAS  PubMed  Google Scholar 

  11. Braun-Quentin C, Billes C, Bowing B, Kotzot D (1996) MURCS association: case report and review. J Med Genet 33(7):618–620

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Morcel K, Camborieux L, Guerrier D (2007) Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome. Orphanet J Rare Dis 2:13

    Article  PubMed  PubMed Central  Google Scholar 

  13. Quan L, Smith DW (1973) The VATER association. Vertebral defects, Anal atresia, T-E fistula with esophageal atresia, Radial and Renal dysplasia: a spectrum of associated defects. J Pediatr 82(1):104–107

    Article  CAS  PubMed  Google Scholar 

  14. Botto LD, Khoury MJ, Mastroiacovo P, Castilla EE, Moore CA, Skjaerven R et al (1997) The spectrum of congenital anomalies of the VATER association: an international study. Am J Med Genet 71(1):8–15

    Article  CAS  PubMed  Google Scholar 

  15. van Bever Y, van den Ende JJ, Richieri-Costa A (1992) Oculo-auriculo-vertebral complex and uncommon associated anomalies: report on 8 unrelated Brazilian patients. Am J Med Genet 44(5):683–690

    Article  PubMed  Google Scholar 

  16. Guerrier D, Mouchel T, Pasquier L, Pellerin I (2006) The Mayer-Rokitansky-Kuster-Hauser syndrome (congenital absence of uterus and vagina)–phenotypic manifestations and genetic approaches. J Negat Results Biomed 5:1

    Article  PubMed  PubMed Central  Google Scholar 

  17. Schimke RN, King CR (1980) Hereditary urogenital adysplasia. Clin Genet 18(6):417–420

    Article  CAS  PubMed  Google Scholar 

  18. Opitz JM (1987) Vaginal atresia (von Mayer-Rokitansky-Kuster or MRK anomaly) in hereditary renal adysplasia (HRA). Am J Med Genet 26(4):873–876

    Article  CAS  PubMed  Google Scholar 

  19. Simpson JL (1999) Genetics of the female reproductive ducts. Am J Med Genet 89(4):224–239

    Article  CAS  PubMed  Google Scholar 

  20. Hoffmann W, Grospietsch G, Kuhn W (1976) Thalidomide and female genital malformations. Lancet 2(7989):794

    Article  CAS  PubMed  Google Scholar 

  21. Rodriguez E, Pombo F, Alvarez C, Arnal F (1998) Tumor in ectopic omental ovary in Mayer-Rokitansky-Kuster-Hauser syndrome: cT findings. J Comput Assist Tomogr 22:758–759

    Article  CAS  PubMed  Google Scholar 

  22. Oppelt P, Strissel PL, Kellermann A, Seeber S, Humeny A, Beckmann MW et al (2005) DNA sequence variations of the entire anti-Mullerian hormone (AMH) gene promoter and AMH protein expression in patients with the Mayer-Rokitanski-Kuster-Hauser syndrome. Hum Reprod 20(1):149–157

    Article  CAS  PubMed  Google Scholar 

  23. Rall K, Barresi G, Walter M, Poths S, Haebig K, Schaeferhoff K et al (2011) A combination of transcriptome and methylation analyses reveals embryologically-relevant candidate genes in MRKH patients. Orphanet J Rare Dis 6:32

    Article  PubMed  PubMed Central  Google Scholar 

  24. van Lingen BL, Reindollar RH, Davis AJ, Gray MR (1998) Further evidence that the WT1 gene does not have a role in the development of the derivatives of the mullerian duct. Am J Obstet Gynecol 179(3 Pt 1):597–603

    Article  PubMed  Google Scholar 

  25. Burel A, Mouchel T, Odent S, Tiker F, Knebelmann B, Pellerin I et al (2006) Role of HOXA7 to HOXA13 and PBX1 genes in various forms of MRKH syndrome (congenital absence of uterus and vagina). J Negat Results Biomed 5:4

    Article  PubMed  PubMed Central  Google Scholar 

  26. van Lingen BL, Reindollar RH, Davis AJ, Gray MR (1998) Molecular genetic analysis of the PAX2 gene in patients with congenital absence of uterus and vagina (abstract). Fertil Steril 70:S402

    Google Scholar 

  27. Rall K, Eisenbeis S, Barresi G, Rückner D, Walter M, Poths S et al (2015) Mayer-Rokitansky-Küster-Hauser syndrome discordance in monozygotic twins: matrix metalloproteinase 14, low-density lipoprotein receptor-related protein 10, extracellular matrix, and neoangiogenesis genes identified as candidate genes in a tissue-specific mosaicism. Fertil Steril 103(2):494.e3–502.e3

    Article  CAS  Google Scholar 

  28. Ledig S, Brucker S, Barresi G, Schomburg J, Rall K, Wieacker P (2012) Frame shift mutation of LHX1 is associated with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome. Hum Reprod 27(9):2872–2875

    Article  CAS  PubMed  Google Scholar 

  29. Palumbo P, Antona V, Palumbo O, Piccione M, Nardello R, Fontana A, Carella M, Corsello G (2014) Variable phenotype in 17q12 microdeletions: clinical and molecular characterization of a new case. Gene 538(2):373–378

    Article  CAS  PubMed  Google Scholar 

  30. Cramer DW, Goldstein DP, Fraer C, Reichardt JK (1996) Vaginal agenesis (Mayer-Rokitansky-Kuster-Hauser syndrome) associated with the N314D mutation of galactose-1-phosphate uridyl transferase (GALT). Mol Hum Reprod 2(3):145–148

    Article  CAS  PubMed  Google Scholar 

  31. Klipstein S, Bhagavath B, Topipat C, Sasur L, Reindollar RH, Gray MR (2003) The N314D polymorphism of the GALT gene is not associated with congenital absence of the uterus and vagina. Mol Hum Reprod 9(3):171–174

    Article  CAS  PubMed  Google Scholar 

  32. Timmreck LS, Gray MR, Handelin B, Allito B, Rohlfs E, Davis AJ et al (2003) Analysis of cystic fibrosis transmembrane conductance regulator gene mutations in patients with congenital absence of the uterus and vagina. Am J Med Genet A 120A(1):72–76

    Article  PubMed  Google Scholar 

  33. Mendelsohn C, Lohnes D, Decimo D, Lufkin T, LeMeur M, Chambon P et al (1994) Function of the retinoic acid receptors (RARs) during development (II). Multiple abnormalities at various stages of organogenesis in RAR double mutants. Development 120(10):2749–2771

    CAS  PubMed  Google Scholar 

  34. Kastner P, Mark M, Ghyselinck N, Krezel W, Dupe V, Grondona JM et al (1997) Genetic evidence that the retinoid signal is transduced by heterodimeric RXR/RAR functional units during mouse development. Development 124(2):313–326

    CAS  PubMed  Google Scholar 

  35. Kucheria K, Taneja N, Kinra G (1988) Autosomal translocation of chromosomes 12q & 14q in mullerian duct failure. Indian J Med Res 87:290–292

    CAS  PubMed  Google Scholar 

  36. Cheroki C, Krepischi-Santos AC, Rosenberg C, Jehee FS, Mingroni-Netto RC, Pavanello Filho I et al (2006) Report of a del22q11 in a patient with Mayer-Rokitansky-Kuster-Hauser (MRKH) anomaly and exclusion of WNT-4, RAR-gamma, and RXR-alpha as major genes determining MRKH anomaly in a study of 25 affected women. Am J Med Genet 140A(12):1339–1342

    Article  CAS  Google Scholar 

  37. Devriendt K, Moerman P, Van Schoubroeck D, Vandenberghe K, Fryns JP (1997) Chromosome 22q11 deletion presenting as the Potter sequence. J Med Genet 34(5):423–425

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Ledig S, Schippert C, Strick R, Beckmann MW, Oppelt PG, Wieacker P (2011) Recurrent aberrations identified by array-CGH in patients with Mayer-Rokitansky-Kuster-Hauser syndrome. Fertil Steril 95(5):1589–1594

    Article  CAS  PubMed  Google Scholar 

  39. Nik-Zainal S, Strick R, Storer M, Huang N, Rad R, Willatt L et al (2011) High incidence of recurrent copy number variants in patients with isolated and syndromic Mullerian aplasia. J Med Genet 48(3):197–204

    Article  PubMed  PubMed Central  Google Scholar 

  40. Morcel K, Watrin T, Pasquier L, Rochard L, Le Caignec C, Dubourg C et al (2011) Utero-vaginal aplasia (Mayer-Rokitansky-Kuster-Hauser syndrome) associated with deletions in known DiGeorge or DiGeorge-like loci. Orphanet J Rare Dis 6:9

    Article  PubMed  PubMed Central  Google Scholar 

  41. Ryan AK, Goodship JA, Wilson DI, Philip N, Levy A, Seidel H et al (1997) Spectrum of clinical features associated with interstitial chromosome 22q11 deletions: a European collaborative study. J Med Genet 34(10):798–804

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Bendavid C, Pasquier L, Watrin T, Morcel K, Lucas J, Gicquel I et al (2007) Phenotypic variability of a 4q34–> qter inherited deletion: MRKH syndrome in the daughter, cardiac defect and Fallopian tube cancer in the mother. Eur J Med Genet 50(1):66–72

    Article  PubMed  Google Scholar 

  43. Cheroki C, Krepischi-Santos AC, Szuhai K, Brenner V, Kim CA, Otto PA et al (2008) Genomic imbalances associated with mullerian aplasia. J Med Genet 45(4):228–232

    Article  CAS  PubMed  Google Scholar 

  44. Bernardini L, Gimelli S, Gervasini C, Carella M, Baban A, Frontino G et al (2009) Recurrent microdeletion at 17q12 as a cause of Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome: two case reports. Orphanet J Rare Dis 4(1):25

    Article  PubMed  PubMed Central  Google Scholar 

  45. Taylor HS (2000) The role of HOX genes in human implantation. Hum Reprod Update 6(1):75–79

    Article  CAS  PubMed  Google Scholar 

  46. Satokata I, Benson G, Maas R (1995) Sexually dimorphic sterility phenotypes in Hoxa10-deficient mice. Nature 374(6521):460–463

    Article  CAS  PubMed  Google Scholar 

  47. Ekici AB, Strissel PL, Oppelt PG, Renner SP, Brucker S, Beckmann MW, Strick R (2013) HOXA10 and HOXA13 sequence variations in human female genital malformations including congenital absence of the uterus and vagina. Gene 518(2):267–272

    Article  CAS  PubMed  Google Scholar 

  48. Gendron RL, Paradis H, Hsieh-Li HM, Lee DW, Potter SS, Markoff E (1997) Abnormal uterine stromal and glandular function associated with maternal reproductive defects in Hoxa-11 null mice. Biol Reprod 56(5):1097–1105

    Article  CAS  PubMed  Google Scholar 

  49. Warot X, Fromental-Ramain C, Fraulob V, Chambon P, Dolle P (1997) Gene dosage-dependent effects of the Hoxa-13 and Hoxd-13 mutations on morphogenesis of the terminal parts of the digestive and urogenital tracts. Development 124(23):4781–4791

    CAS  PubMed  Google Scholar 

  50. Patterson LT, Potter SS (2003) Hox genes and kidney patterning. Curr Opin Nephrol Hypertens 12(1):19–23

    Article  CAS  PubMed  Google Scholar 

  51. Wellik DM, Capecchi MR (2003) Hox10 and Hox11 genes are required to globally pattern the mammalian skeleton. Science 301(5631):363–367

    Article  CAS  PubMed  Google Scholar 

  52. Devriendt K, Jaeken J, Matthijs G, Van Esch H, Debeer P, Gewillig M et al (1999) Haploinsufficiency of the HOXA gene cluster, in a patient with hand-foot-genital syndrome, velopharyngeal insufficiency, and persistent patent Ductus botalli. Am J Hum Genet 65(1):249–251

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. Gervasini C, Grati FR, Lalatta F, Tabano S, Gentilin B, Colapietro P et al (2010) SHOX duplications found in some cases with type I Mayer-Rokitansky-Kuster-Hauser syndrome. Genet Med 12(10):634–640

    Article  PubMed  Google Scholar 

  54. Peifer M, Polakis P (2000) Wnt signaling in oncogenesis and embryogenesis–a look outside the nucleus. Science 287(5458):1606–1609

    Article  CAS  PubMed  Google Scholar 

  55. Miller C, Pavlova A, Sassoon DA (1998) Differential expression patterns of Wnt genes in the murine female reproductive tract during development and the estrous cycle. Mech Dev 76(1–2):91–99

    Article  CAS  PubMed  Google Scholar 

  56. Vainio S, Heikkila M, Kispert A, Chin N, McMahon AP (1999) Female development in mammals is regulated by Wnt-4 signalling. Nature 397(6718):405–409

    Article  CAS  PubMed  Google Scholar 

  57. Mericskay M, Kitajewski J, Sassoon D (2004) Wnt5a is required for proper epithelial-mesenchymal interactions in the uterus. Development 131(9):2061–2072

    Article  CAS  PubMed  Google Scholar 

  58. Miller C, Degenhardt K, Sassoon DA (1998) Fetal exposure to DES results in de-regulation of Wnt7a during uterine morphogenesis. Nat Genet 20(3):228–230

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  59. Ravel C, Lorenco D, Dessolle L, Mandelbaum J, McElreavey K, Darai E et al (2009) Mutational analysis of the WNT gene family in women with Mayer-Rokitansky-Kuster-Hauser syndrome. Fertil Steril 91(4 Suppl):1604–1607

    Article  CAS  PubMed  Google Scholar 

  60. Timmreck LS, Pan HA, Reindollar RH, Gray MR (2003) WNT7A mutations in patients with Mullerian duct abnormalities. J Pediatr Adolesc Gynecol 16(4):217–221

    Article  CAS  PubMed  Google Scholar 

  61. Carroll TJ, Park JS, Hayashi S, Majumdar A, McMahon AP (2005) Wnt9b plays a central role in the regulation of mesenchymal to epithelial transitions underlying organogenesis of the mammalian urogenital system. Dev Cell 9(2):283–292

    Article  CAS  PubMed  Google Scholar 

  62. Biason-Lauber A, Konrad D, Navratil F, Schoenle EJ (2004) A WNT4 mutation associated with Mullerian-duct regression and virilization in a 46, XX woman. N Engl J Med 351(8):792–798

    Article  CAS  PubMed  Google Scholar 

  63. Ma W, Li Y, Wang M, Li H, Su T, Li Y, Wang S (2015) Associations of Polymorphisms in WNT9B and PBX1 with Mayer-Rokitansky-Küster-Hauser Syndrome in Chinese Han. PLoS One 10(6):e0130202

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  64. Biason-Lauber A, De Filippo G, Konrad D, Scarano G, Nazzaro A, Schoenle EJ (2007) WNT4 deficiency–a clinical phenotype distinct from the classic Mayer-Rokitansky-Kuster-Hauser syndrome: a case report. Hum Reprod 22(1):224–229

    Article  CAS  PubMed  Google Scholar 

  65. Philibert P, Biason-Lauber A, Rouzier R, Pienkowski C, Paris F, Konrad D et al (2008) Identification and functional analysis of a new WNT4 gene mutation among 28 adolescent girls with primary amenorrhea and mullerian duct abnormalities: a French collaborative study. J Clin Endocrinol Metab 93(3):895–900

    Article  CAS  PubMed  Google Scholar 

  66. Philibert P, Biason-Lauber A, Gueorguieva I, Stuckens C, Pienkowski C, Lebon-Labich B et al (2011) Molecular analysis of WNT4 gene in four adolescent girls with mullerian duct abnormality and hyperandrogenism (atypical Mayer-Rokitansky-Kuster-Hauser syndrome). Fertil Steril 95(8):2683–2686

    Article  CAS  PubMed  Google Scholar 

  67. Clement-Ziza M, Khen N, Gonzales J, Cretolle-Vastel C, Picard JY, Tullio-Pelet A et al (2005) Exclusion of WNT4 as a major gene in Rokitansky-Kuster-Hauser anomaly. Am J Med Genet A 137(1):98–99

    Article  PubMed  Google Scholar 

  68. Sultan C, Biason-Lauber A, Philibert P (2009) Mayer-Rokitansky-Kuster-Hauser syndrome: recent clinical and genetic findings. Gynecol Endocrinol 25(1):8–11

    Article  CAS  PubMed  Google Scholar 

  69. Drummond JB, Reis FM, Boson WL, Silveira LF, Bicalho MA, De Marco L (2008) Molecular analysis of the WNT4 gene in 6 patients with Mayer-Rokitansky-Kuster-Hauser syndrome. Fertil Steril 90(3):857–859

    Article  CAS  PubMed  Google Scholar 

  70. Griesinger G, Dafopoulos K, Schultze-Mosgau A, Schroder A, Felberbaum R, Diedrich K (2005) Mayer-Rokitansky-Kuster-Hauser syndrome associated with thrombocytopenia-absent radius syndrome. Fertil Steril 83(2):452–454

    Article  PubMed  Google Scholar 

  71. Childs AJ, Hall LL (2005) Hot clues to the etiology of Mayer-Rokitansky-Kuster-Hauser syndrome? Fertil Steril 84(2):544–545 (author reply 5)

    Article  PubMed  Google Scholar 

  72. Greenhalgh KL, Howell RT, Bottani A, Ancliff PJ, Brunner HG, Verschuuren-Bemelmans CC et al (2002) Thrombocytopenia-absent radius syndrome: a clinical genetic study. J Med Genet 39(12):876–881

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  73. Fakih MH, Williamson HO, Seymour EQ, Pai S (1987) Concurrence of the Holt-Oram syndrome and the Rokitansky-Kuster-Hauser syndrome. A case report. J Reprod Med 32(7):549–550

    CAS  PubMed  Google Scholar 

  74. Ulrich U, Schrickel J, Dorn C, Richter O, Lewalter T, Luderitz B et al (2004) Mayer-von Rokitansky-Kuster-Hauser syndrome in association with a hitherto undescribed variant of the Holt-Oram syndrome with an aorto-pulmonary window. Hum Reprod 19(5):1201–1203

    Article  CAS  PubMed  Google Scholar 

  75. McDonough PG (2005) Hot clues to the etiology of Mayer-Rokitansky-Kuster-Hauser syndrome? Fertil Steril 84(2):545

    Article  PubMed  Google Scholar 

  76. McGowan R, Tydeman G, Shapiro D, Craig T, Morrison N, Logan S et al (2015) DNA copy number variations are important in the complex genetic architecture of müllerian disorders. Fertil Steril 103(4):1021.e1–1030.e1

    Article  CAS  Google Scholar 

  77. Chen MJ, Wei SY, Yang WS, Wu TT, Li HY, Ho HN et al (2015) Concurrent exome-targeted next-generation sequencing and single nucleotide polymorphism array to identify the causative genetic aberrations of isolated Mayer-Rokitansky-Küster-Hauser syndrome. Hum Reprod 30(7):1732–1742

    Article  PubMed  Google Scholar 

  78. Brucker S, Bungartz J, Rall K (2009) Die 3 A (Asymptomatisch, Amenorrhö, Aplasie) der Vaginalaplasie—kein differentialdiagnostisches Chamäleon. Geburtshilfe Frauenheilkd 69:568–575

    Article  Google Scholar 

  79. Rosenberg HK, Sherman NH, Tarry WF, Duckett JW, Snyder HM (1986) Mayer-Rokitansky-Kuster-Hauser syndrome: US aid to diagnosis. Radiology 161(3):815–819

    Article  CAS  PubMed  Google Scholar 

  80. Botsis D, Deligeoroglou E, Christopoulos P, Aravantinos L, Papagianni V, Creatsas G (2005) Ultrasound imaging to evaluate Creatsas vaginoplasty. Int J Gynaecol Obstet 89(1):31–34

    Article  CAS  PubMed  Google Scholar 

  81. Troiano RN, McCarthy SM (2004) Mullerian duct anomalies: imaging and clinical issues. Radiology 233(1):19–34

    Article  PubMed  Google Scholar 

  82. Coyotupa J, Buster J, Parlow AF, Dignam WJ (1973) Normal cyclical patterns of serum gonadotropins and ovarian steroids despite congenital absence of the uterus. J Clin Endocrinol Metab 36(2):395–396

    Article  CAS  PubMed  Google Scholar 

  83. Fraser IS, Baird DT, Hobson BM, Michie EA, Hunter W (1973) Cyclical ovarian function in women with congenital absence of the uterus and vagina. J Clin Endocrinol Metab 36(4):634–637

    Article  CAS  PubMed  Google Scholar 

  84. Rall K, Conzelmann G, Schäffeler N, Henes M, Wallwiener D, Möhrle M, Brucker SY (2014) Acne and PCOS are less frequent in women with Mayer-Rokitansky-Küster-Hauser syndrome despite a high rate of hyperandrogenemia: a cross-sectional study. Reprod Biol Endocrinol 18(12):23

    Article  CAS  Google Scholar 

  85. Marsh CA, Will MA, Smorgick N, Quint EH, Hussain H, Smith YR (2013) Uterine remnants and pelvic pain in females with Mayer-Rokitansky-Küster-Hauser syndrome. J Pediatr Adolesc Gynecol 26(3):199–202

    Article  PubMed  Google Scholar 

  86. Poland ML, Evans TN (1985) Psychologic aspects of vaginal agenesis. J Reprod Med 30(4):340–344

    CAS  PubMed  Google Scholar 

  87. Bean EJ, Mazur T, Robinson AD (2009) Mayer-rokitansky-kuster-hauser syndrome: sexuality, psychological effects, and quality of life. J Pediatr Adolesc Gynecol 22(6):339–346

    Article  CAS  PubMed  Google Scholar 

  88. Heller-Boersma JG, Schmidt UH, Edmonds DK (2009) Psychological distress in women with uterovaginal agenesis (Mayer-Rokitansky-Kuster-Hauser Syndrome, MRKH). Psychosomatics 50(3):277–281

    Article  PubMed  Google Scholar 

  89. Liao LM, Conway GS, Ismail-Pratt I, Bikoo M, Creighton SM (2011) Emotional and sexual wellness and quality of life in women with Rokitansky syndrome. Am J Obstet Gynecol 205(2):117.e1–117.e6

    Article  Google Scholar 

  90. David A, Carmil D, Bar-David E, Serr DM (1975) Congenital absence of the vagina. Clinical and psychologic aspects. Obstet Gynecol 46(4):407–409

    CAS  PubMed  Google Scholar 

  91. Weijenborg PT, ter Kuile MM (2000) The effect of a group programme on women with the Mayer-Rokitansky-Kuster-Hauser syndrome. BJOG 107(3):365–368

    Article  CAS  PubMed  Google Scholar 

  92. Committee on Adolescent Health Care (2013) Committee opinion: no. 562: Müllerian agenesis: diagnosis, management, and treatment. Obstet Gynecol 121(5):1134–1137

    Article  Google Scholar 

  93. Heller-Boersma JG, Schmidt UH, Edmonds DK (2007) A randomized controlled trial of a cognitive-behavioural group intervention versus waiting-list control for women with uterovaginal agenesis (Mayer-Rokitansky-Kuster-Hauser syndrome: MRKH). Hum Reprod 22(8):2296–2301

    Article  CAS  PubMed  Google Scholar 

  94. Egarter C, Huber J (1988) Successful stimulation and retrieval of oocytes in patient with Mayer-Rokitansky-Kuster syndrome. Lancet 1(8597):1283

    Article  CAS  PubMed  Google Scholar 

  95. Yovich JL, Hoffman TD (1988) IVF surrogacy and absent uterus syndromes. Lancet 2(8606):331–332

    Article  Google Scholar 

  96. Batzer FR, Corson SL, Gocial B, Daly DC, Go K, English ME (1992) Genetic offspring in patients with vaginal agenesis: specific medical and legal issues. Am J Obstet Gynecol 167(5):1288–1292

    Article  CAS  PubMed  Google Scholar 

  97. Petrozza JC, Gray MR, Davis AJ, Reindollar RH (1997) Congenital absence of the uterus and vagina is not commonly transmitted as a dominant genetic trait: outcomes of surrogate pregnancies. Fertil Steril 67(2):387–389

    Article  CAS  PubMed  Google Scholar 

  98. Wood EG, Batzer FR, Corson SL (1999) Ovarian response to gonadotrophins, optimal method for oocyte retrieval and pregnancy outcome in patients with vaginal agenesis. Hum Reprod 14(5):1178–1181

    Article  CAS  PubMed  Google Scholar 

  99. Beski S, Gorgy A, Venkat G, Craft IL, Edmonds K (2000) Gestational surrogacy: a feasible option for patients with Rokitansky syndrome. Hum Reprod 15(11):2326–2328

    Article  CAS  PubMed  Google Scholar 

  100. Van Waart J, Kruger TF (2000) Surrogate pregnancies in patients with Mayer-Rokitansky-Kustner-Hauser syndrome and severe teratozoospermia. Arch Androl 45(2):95–97

    Article  PubMed  Google Scholar 

  101. Esfandiari N, Claessens EA, O’Brien A, Gotlieb L, Casper RF (2004) Gestational carrier is an optimal method for pregnancy in patients with vaginal agenesis (Rokitansky syndrome). Int J Fertil Womens Med 49(2):79–82

    PubMed  Google Scholar 

  102. Friedler S, Grin L, Liberti G, Saar-Ryss B, Rabinson Y, Meltzer S (2016) The reproductive potential of patients with Mayer-Rokitansky-Küster-Hauser syndrome using gestational surrogacy: a systematic review. Reprod Biomed Online 32(1):54–61

    Article  PubMed  Google Scholar 

  103. Jones BP, Saso S, Yazbek J, Smith JR (2016) Uterine transplantation: past, present and future. BJOG 123(9):1434–1438

    Article  CAS  PubMed  Google Scholar 

  104. Lefkowitz A, Edwards M, Balayla J (2013) Ethical considerations in the era of the uterine transplant: an update of the montreal criteria for the ethical feasibility of uterine transplantation. Fertil Steril 100(4):924–926

    Article  PubMed  Google Scholar 

  105. Brännström M, Bokström H, Dahm-Kähler P, Diaz-Garcia C, Ekberg J, Enskog A et al (2016) One uterus bridging three generations: first live birth after mother-to-daughter uterus transplantation. Fertil Steril 106(2):261–266

    Article  PubMed  Google Scholar 

  106. Kuehn BM (2017) us uterus transplant trials under way. JAMA 317(10):1005–1007

    Article  PubMed  Google Scholar 

  107. Frank RT (1938) The formation of an artificial vagina without operation. Am J Obstet Gynecol 35:1053–1055

    Article  Google Scholar 

  108. Frank RT (1940) The formation of an artificial vagina without operation. NY State J Med 40:1669

    Google Scholar 

  109. Rock JA, Reeves LA, Retto H, Baramki TA, Zacur HA, Jones HW Jr (1983) Success following vaginal creation for Mullerian agenesis. Fertil Steril 39(6):809–813

    Article  CAS  PubMed  Google Scholar 

  110. Broadbent TR, Woolf RM (1977) Congenital absence of the vagina: reconstruction without operation. Br J Plast Surg 30(2):118–122

    Article  CAS  PubMed  Google Scholar 

  111. Karim RB, Hage JJ, Dekker JJ, Schoot CM (1995) Evolution of the methods of neovaginoplasty for vaginal aplasia. Eur J Obstet Gynecol Reprod Biol 58(1):19–27

    Article  CAS  PubMed  Google Scholar 

  112. Bellati F, Calcagno M, Pastore M, Maffucci D, Celentano C, Boni T et al (2009) Vaginal apex necrosis following use of the Frank method of dilation for vaginal agenesis due to Mayer-Rokitansky-Kuster-Hauser syndrome. Int J Gynaecol Obstet 107(3):254

    Article  PubMed  Google Scholar 

  113. Ingram JM (1981) The bicycle seat stool in the treatment of vaginal agenesis and stenosis: a preliminary report. Am J Obstet Gynecol 140(8):867–873

    Article  CAS  PubMed  Google Scholar 

  114. Roberts CP, Haber MJ, Rock JA (2001) Vaginal creation for mullerian agenesis. Am J Obstet Gynecol 185(6):1349–1352 (discussion 52-3)

    Article  CAS  PubMed  Google Scholar 

  115. Williams JK, Ingram JM, Welden SW (1984) Management of noncongenital vaginal stenosis and distortion by the bicycle seat stool pressure technique. Am J Obstet Gynecol 150(2):166–167

    Article  CAS  PubMed  Google Scholar 

  116. ACOG Committee Opinion No (2006) 355: vaginal agenesis: diagnosis, management, and routine care. Obstet Gynecol 108(6):1605–1609

    Article  Google Scholar 

  117. Laufer MR (2002) Congenital absence of the vagina: in search of the perfect solution. When, and by what technique, should a vagina be created? Curr Opin Obstet Gynecol 14(5):441–444

    Article  PubMed  Google Scholar 

  118. McQuillan SK, Grover SR (2014) Systematic review of sexual function and satisfaction following the management of vaginal agenesis. Int Urogynecol J 25(10):1313–1320

    Article  PubMed  Google Scholar 

  119. McIndoe AH, Banister JB (1938) An operation for the cure of congenital absence of the vagina. J Obstet Gynaecol Br Emp 45:490

    Article  Google Scholar 

  120. Seccia A, Salgarello M, Sturla M, Loreti A, Latorre S, Farallo E (2002) Neovaginal reconstruction with the modified McIndoe technique: a review of 32 cases. Ann Plast Surg 49(4):379–384

    Article  PubMed  Google Scholar 

  121. Ozek C, Gurler T, Alper M, Gundogan H, Bilkay U, Songur E et al (1999) Modified McIndoe procedure for vaginal agenesis. Ann Plast Surg 43(4):393–396

    Article  CAS  PubMed  Google Scholar 

  122. Alessandrescu D, Peltecu GC, Buhimschi CS, Buhimschi IA (1996) Neocolpopoiesis with split-thickness skin graft as a surgical treatment of vaginal agenesis: retrospective review of 201 cases. Am J Obstet Gynecol 175(1):131–138

    Article  CAS  PubMed  Google Scholar 

  123. Salvatore CA, Lodovicci O (1978) Vaginal agenesis: an analysis of ninety cases. Acta Obstet Gynecol Scand 57(1):89–94

    Article  CAS  PubMed  Google Scholar 

  124. Buss JG, Lee RA (1989) McIndoe procedure for vaginal agenesis: results and complications. Mayo Clin Proc 64(7):758–761

    Article  CAS  PubMed  Google Scholar 

  125. Rock JA, Breech LL (2003) Surgery for anomalies of the Mullerian ducts. In: Rock JA, Jones HWR (eds) Te Linde’s operative gynecology, 9th edn. Lippincott Williams & Wilkins, Philadelphia, pp 705–752

    Google Scholar 

  126. Klingele CJ, Gebhart JB, Croak AJ, DiMarco CS, Lesnick TG, Lee RA (2003) McIndoe procedure for vaginal agenesis: long-term outcome and effect on quality of life. Am J Obstet Gynecol 189(6):1569–1572 (discussion 72-3)

    Article  PubMed  Google Scholar 

  127. Tancer ML, Katz M, Veridiano NP (1979) Vaginal epithelialization with human amnion. Obstet Gynecol 54(3):345–349

    CAS  PubMed  Google Scholar 

  128. Chen ZJ, Chen MY, Chen C, Wu N (1989) Vaginal reconstruction with an axial subcutaneous pedicle flap from the inferior abdominal wall: a new method. Plast Reconstr Surg 83(6):1005–1012

    Article  CAS  PubMed  Google Scholar 

  129. Wee JT, Joseph VT (1989) A new technique of vaginal reconstruction using neurovascular pudendal-thigh flaps: a preliminary report. Plast Reconstr Surg 83(4):701–709

    Article  CAS  PubMed  Google Scholar 

  130. Selvaggi G, Monstrey S, Depypere H, Blondeel P, Van Landuyt K, Hamdi M et al (2003) Creation of a neovagina with use of a pudendal thigh fasciocutaneous flap and restoration of uterovaginal continuity. Fertil Steril 80(3):607–611

    Article  PubMed  Google Scholar 

  131. Hwang WY, Chang TS, Sun P, Chung TH (1985) Vaginal reconstruction using labia minora flaps in congenital total absence. Ann Plast Surg 15(6):534–537

    Article  CAS  PubMed  Google Scholar 

  132. Benedetti Panici P, Maffucci D, Ceccarelli S, Vescarelli E, Perniola G, Muzii L, Marchese C (2015) Autologous in vitro cultured vaginal tissue for vaginoplasty in women with Mayer-Rokitansky-Küster-Hauser syndrome: anatomic and functional results. J Minim Invasive Gynecol 22(2):205–211

    Article  PubMed  Google Scholar 

  133. Dornelas J, Jármy-Di Bella ZI, Heinke T, Kajikawa MM, Takano CC, Zucchi EV, Girão MJ (2012) Vaginoplasty with oxidized cellulose: anatomical, functional and histological evaluation. Eur J Obstet Gynecol Reprod Biol 163(2):204–209

    Article  CAS  PubMed  Google Scholar 

  134. Zhu L, Zhou H, Sun Z, Lou W, Lang J (2013) Anatomic and sexual outcomes after vaginoplasty using tissue-engineered biomaterial graft in patients with Mayer-Rokitansky-Küster-Hauser syndrome: a new minimally invasive and effective surgery. J Sex Med 10(6):1652–1658

    Article  PubMed  Google Scholar 

  135. Akle CA, Adinolfi M, Welsh KI, Leibowitz S, McColl I (1981) Immunogenicity of human amniotic epithelial cells after transplantation into volunteers. Lancet 2(8254):1003–1005

    Article  CAS  PubMed  Google Scholar 

  136. Karjalainen O, Myllynen L, Kajanoja P, Tenhunen A, Purola E, Timonen S (1980) Management of vaginal agenesis. Ann Chir Gynaecol 69(1):37–41

    CAS  PubMed  Google Scholar 

  137. Ashworth MF, Morton KE, Dewhurst J, Lilford RJ, Bates RG (1986) Vaginoplasty using amnion. Obstet Gynecol 67(3):443–446

    CAS  PubMed  Google Scholar 

  138. Morton KE, Dewhurst CJ (1986) Human amnion in the treatment of vaginal malformations. Br J Obstet Gynaecol 93(1):50–54

    Article  CAS  PubMed  Google Scholar 

  139. Sharma D, Dahiya K, Chechi K, Sirohiwal S (2008) Vaginoplasty with amnion grafting: an experience. J Gynecol Surg 24:61–65

    Article  Google Scholar 

  140. Fotopoulou C, Sehouli J, Gehrmann N, Schoenborn I, Lichtenegger W (2010) Functional and anatomic results of amnion vaginoplasty in young women with Mayer-Rokitansky-Küster-Hauser syndrome. Fertil Steril 94(1):317–323

    Article  PubMed  Google Scholar 

  141. Jackson ND, Rosenblatt PL (1994) Use of interceed absorbable adhesion barrier for vaginoplasty. Obstet Gynecol 84(6):1048–1050

    CAS  PubMed  Google Scholar 

  142. Williams EA (1964) Congenital absence of the vagina: a simple operation for its relief. J Obstet Gynaecol Br Commonw 71:511–512

    Article  CAS  PubMed  Google Scholar 

  143. Creatsas G, Deligeoroglou E, Makrakis E, Kontoravdis A, Papadimitriou L (2001) Creation of a neovagina following Williams vaginoplasty and the Creatsas modification in 111 patients with Mayer-Rokitansky-Kuster-Hauser syndrome. Fertil Steril 76(5):1036–1040

    Article  CAS  PubMed  Google Scholar 

  144. Creatsas G, Deligeoroglou E (2007) Expert opinion: vaginal aplasia: creation of a neovagina following the Creatsas vaginoplasty. Eur J Obstet Gynecol Reprod Biol 131(2):248–252

    Article  PubMed  Google Scholar 

  145. Creatsas G, Deligeoroglou E, Christopoulos P (2010) Creation of a neovagina after Creatsas modification of Williams vaginoplasty for the treatment of 200 patients with Mayer-Rokitansky-Kuster-Hauser syndrome. Fertil Steril 94(5):1848–1852

    Article  PubMed  Google Scholar 

  146. Williams EA (1976) Uterovaginal agenesis. Ann R Coll Surg Engl 58(4):266–277

    CAS  PubMed  PubMed Central  Google Scholar 

  147. Feroze RM, Dewhurst CJ, Welply G (1975) Vaginoplasty at the Chelsea hospital for women: a comparison of two techniques. Br J Obstet Gynaecol 82(7):536–540

    Article  CAS  PubMed  Google Scholar 

  148. Capraro VJ, Gallego MB (1976) Vaginal agenesis. Am J Obstet Gynecol 124(1):98–107

    Article  CAS  PubMed  Google Scholar 

  149. Creatsas GC (1991) Creatsas modification of Williams vaginoplasty. J Gynecol Surg 7:219

    Article  Google Scholar 

  150. Vecchietti G (1965) [Creation of an artificial vagina in Rokitansky-Kuster-Hauser syndrome]. Attual Ostet Ginecol 11(2):131–147

    CAS  PubMed  Google Scholar 

  151. Vecchietti G (1980) Neovagina in Rokitanksy-Kuster-Hauser syndrome. Gynakologe 13(3):112–115

    CAS  PubMed  Google Scholar 

  152. Borruto F (1992) Mayer-Rokitansky-Kuster Syndrome: Vecchietti’s personal series. Clin Exp Obstet Gynecol 19(4):273–274

    CAS  PubMed  Google Scholar 

  153. Brun JL, Belleannee G, Grafeille N, Aslan AF, Brun GH (2002) Long-term results after neovagina creation in Mayer-Rokitanski-Kuster-Hauser syndrome by Vecchietti’s operation. Eur J Obstet Gynecol Reprod Biol 103(2):168–172

    Article  PubMed  Google Scholar 

  154. Gauwerky JF, Wallwiener D, Bastert G (1992) An endoscopically assisted technique for construction of a neovagina. Arch Gynecol Obstet 252(2):59–63

    Article  CAS  PubMed  Google Scholar 

  155. Laffargue F, Giacalone PL, Boulot P, Vigouroux B, Hedon B, Benos P (1995) A laparoscopic procedure for the treatment of vaginal aplasia. Br J Obstet Gynaecol 102(7):565–567

    Article  CAS  PubMed  Google Scholar 

  156. Fedele L, Bianchi S, Frontino G, Fontana E, Restelli E, Bruni V (2008) The laparoscopic Vecchietti’s modified technique in Rokitansky syndrome: anatomic, functional, and sexual long-term results. Am J Obstet Gynecol 198(4):377 e1–377 e6

    Article  Google Scholar 

  157. Fedele L, Bianchi S, Berlanda N, Fontana E, Raffaelli R, Bulfoni A et al (2006) Neovaginal mucosa after Vecchietti’s laparoscopic operation for Rokitansky syndrome: structural and ultrastructural study. Am J Obstet Gynecol 195(1):56–61

    Article  PubMed  Google Scholar 

  158. Brucker SY, Gegusch M, Zubke W, Rall K, Gauwerky JF, Wallwiener D (2008) Neovagina creation in vaginal agenesis: development of a new laparoscopic Vecchietti-based procedure and optimized instruments in a prospective comparative interventional study in 101 patients. Fertil Steril 90(5):1940–1952

    Article  PubMed  Google Scholar 

  159. Rall K, Schickner MC, Barresi G, Schönfisch B, Wallwiener M, Wallwiener CW, Wallwiener D, Brucker SY (2014) Laparoscopically assisted neovaginoplasty in vaginal agenesis: a long-term outcome study in 240 patients. J Pediatr Adolesc Gynecol 27(6):379–385

    Article  PubMed  Google Scholar 

  160. Çetin C, Soysal C, Ürünsak İF, Api M, Çetin T (2016) Long-term outcomes of laparoscopic bean vaginoplasty (Modified Vecchietti Procedure) for Mayer-Rokitansky-Kuster-Hauser Syndrome. J Laparoendosc Adv Surg Tech A 26(8):591–595

    Article  PubMed  Google Scholar 

  161. Davydov SN (1969) Colpopoeisis from the peritoneum of the uterorectal space. Akush Ginekol (Mosk) 45(12):55–57

    CAS  Google Scholar 

  162. Willemsen WN, Kluivers KB (2015) Long-term results of vaginal construction with the use of Frank dilation and a peritoneal graft (Davydov procedure) in patients with Mayer-Rokitansky-Küster syndrome. Fertil Steril 103(1):220-7.e1

    Article  PubMed  Google Scholar 

  163. Fedele L, Frontino G, Restelli E, Ciappina N, Motta F, Bianchi S (2010) Creation of a neovagina by Davydov’s laparoscopic modified technique in patients with Rokitansky syndrome. Am J Obstet Gynecol 202(1):33e1-6

    Article  Google Scholar 

  164. Kisku S, Varghese L, Kekre A, Sen S, Karl S, Mathai J, Thomas RJ, Kishore R (2015) Bowel vaginoplasty in children and young women: an institutional experience with 55 patients. Int Urogynecol J 26(10):1441–1448

    Article  PubMed  Google Scholar 

  165. Bouman MB, van Zeijl MC, Buncamper ME, Meijerink WJ, van Bodegraven AA, Mullender MG (2014) Intestinal vaginoplasty revisited: a review of surgical techniques, complications, and sexual function. J Sex Med 11(7):1835–1847

    Article  PubMed  Google Scholar 

  166. Buttram VC Jr (1983) Mullerian anomalies and their management. Fertil Steril 40(2):159–163

    Article  PubMed  Google Scholar 

  167. Fliegner JR, Pepperell RJ (1994) Management of vaginal agenesis with a functioning uterus. Is hysterectomy advisable? Aust N Z J Obstet Gynaecol 34(4):467–470

    Article  CAS  PubMed  Google Scholar 

  168. Niver DH, Barrette G, Jewelewicz R (1980) Congenital atresia of the uterine cervix and vagina: three cases. Fertil Steril 33(1):25–29

    Article  CAS  PubMed  Google Scholar 

  169. Casey AC, Laufer MR (1997) Cervical agenesis: septic death after surgery. Obstet Gynecol 90(4 Pt 2):706–707

    CAS  PubMed  Google Scholar 

  170. Maciulla GJ, Heine MW, Christian CD (1978) Functional endometrial tissue with vaginal agenesis. J Reprod Med 21(6):373–376

    CAS  PubMed  Google Scholar 

  171. Fujimoto VY, Miller JH, Klein NA, Soules MR (1997) Congenital cervical atresia: report of seven cases and review of the literature. Am J Obstet Gynecol 177(6):1419–1425

    Article  CAS  PubMed  Google Scholar 

  172. Singh J, Devi YL (1983) Pregnancy following surgical correction of nonfused mullerian bulbs and absent vagina. Obstet Gynecol 61(2):267–269

    CAS  PubMed  Google Scholar 

  173. Hampton HL, Meeks GR, Bates GW, Wiser WL (1990) Pregnancy after successful vaginoplasty and cervical stenting for partial atresia of the cervix. Obstet Gynecol 76(5 Pt 2):900–901

    Article  CAS  PubMed  Google Scholar 

  174. Nargund G, Parsons J (1996) A successful in vitro fertilization and embryo transfer treatment in a woman with previous vaginoplasty for congenital absence of vagina. Hum Reprod 11(8):1654

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Surgery Working Group, Society of Junior Doctors, Athens, Greece

    Souzana Choussein, Dimitrios Nasioudis, Dimitrios Schizas & Konstantinos P. Economopoulos

  2. Department of Obstetrics, Gynecology and Reproductive Biology, Center for Infertility and Reproductive Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Souzana Choussein

  3. Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, USA

    Dimitrios Nasioudis

  4. 1st Department of Surgery, Laiko General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

    Dimitrios Schizas

  5. Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Konstantinos P. Economopoulos

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CS: Data collection, data analysis, manuscript writing/editing, and final approval of the manuscript. ND: Data analysis, manuscript writing/editing, and final approval of the manuscript. SD: Data analysis, manuscript writing/editing, and final approval of the manuscript. EK: Protocol/project development, data collection, data analysis, manuscript writing/editing, and final approval of the manuscript.

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Choussein, S., Nasioudis, D., Schizas, D. et al. Mullerian dysgenesis: a critical review of the literature. Arch Gynecol Obstet 295, 1369–1381 (2017). https://doi.org/10.1007/s00404-017-4372-2

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