Title: Müllerian agenesis Content: Müllerian agenesis is a rare birth defect. It is also called Mayer-Rokitansky- Kuster-Hauser syndrome or MRKH. People with the syndrome are born without vaginas, cervixes, and wombs. MRKH is a rare genetic disorder that affects a woman's reproductive system. It is characterized by the absence of the uterus and the upper part of the vagina. It occurs in about 1 in 4,500 to 5,000 female births. Women with MRKH syndrome have normal external genitalia and normal secondary sexual characteristics, but they are unable to remain pregnant because they do not have an uterus. The cause of MRKH syndrome is unknown. It probably is a genetic disorder that occurs during fetal development. There is no cure for MRKH syndrome, but treatment options, such as hormone therapy and surgery, can help women manage the condition and lead healthy, fulfilling lives. == Causes of Mullerian agenesis == Mayer- Rokitansky-Küster-Hauser (MRKH) syndrome affects the reproductive system in women. It is characterized by the absence or underdevelopment of the uterus and the upper part of the vagina. The cause of MRKH syndrome is not fully understood, but it is believed to be caused by a combination of genetic and environmental factors. There is no known way to prevent MRKH syndrome. It is not inherited in a predictable pattern, so it is not caused by any specific genetic mutation. Some studies suggest that MRKH syndrome may be caused by a disruption in the development of the Müllerian ducts (the tubes in the embryo that give rise to the uterus and upper vagina) during fetal development. Other possible contributing factors may include exposure to certain medications or chemicals during pregnancy or hormonal imbalances. It is important to note that MRKH syndrome is a rare condition, affecting only about 1 in every 4,500 to 5,000 female infants. If you or someone you know has been diagnosed with MRKH syndrome, it is important to speak with a healthcare provider for further information and support. == Features of Mullerian agenesis == # Absence of uterus and cervix: One of the main features of MRKH syndrome is the absence of the uterus and cervix, which are essential reproductive organs in females. This condition is known as Mullerian agenesis or hypoplasia. # Normal external genitalia: Despite the absence of the uterus and cervix, individuals with MRKH syndrome have normal external genitalia, including a vagina, vulva, and labia. # Amenorrhea: Individuals with MRKH syndrome do not experience menstrual periods due to the absence of the uterus. This is called amenorrhea. # Infertility: As a result of the absence of the uterus, individuals with MRKH syndrome are unable to carry a pregnancy and are generally infertile. # Normal development of secondary sexual characteristics: Despite the absence of reproductive organs, individuals with MRKH syndrome typically develop normal secondary sexual characteristics, such as breast development and pubic hair growth. # Associated skeletal abnormalities: Some individuals with MRKH syndrome may have skeletal abnormalities, such as spinal curvature or abnormal growth of the pelvis. # Psychological and emotional impact: The diagnosis of MRKH syndrome can have a significant psychological and emotional impact on individuals, as it can be a significant source of stress and anxiety. Support from family, friends, and healthcare professionals can be crucial in helping individuals cope with this condition. == Diagnosis of Mullerian Agenesis == It is typically diagnosed in girls and women who are born with a uterus, but have underdeveloped or absent vaginal openings. The diagnosis of MRKH syndrome is usually made during puberty when a person has not begun to menstruate and has no vaginal opening. Other signs and symptoms of MRKH syndrome may include: * Absence of menstrual periods * Short stature or abnormal development of the external genitalia * Absence of breast development * Normal ovaries and external genitalia * Normal external genitalia and internal female reproductive organs The diagnosis of MRKH syndrome is typically made through a combination of physical examination, imaging studies (such as ultrasound or MRI), and blood tests to check hormone levels. In some cases, a biopsy of the uterus may also be performed to confirm the diagnosis. == Treatment == There are several treatment options for MRKH syndrome, which can be customized based on the individual's specific needs and preferences. These options include: # Hormone replacement therapy: This involves taking hormones, such as estrogen and progesterone, to help develop secondary sexual characteristics and maintain bone density. # Vaginal dilation therapy: This involves using dilators to stretch the vagina and improve its function. # Vaginal reconstructive surgery: This involves surgically creating a functioning vagina using techniques such as the McIndoe procedure or the Vecchietti procedure. # Assisted reproductive techniques: For individuals who wish to become pregnant, assisted reproductive techniques, such as in vitro fertilization, may be used. # Psychological support: Many individuals with MRKH syndrome may benefit from psychological support to help them cope with the physical and emotional challenges of the condition. It is important for individuals with MRKH syndrome to work with a healthcare team that includes specialists in reproductive medicine, gynecology, and mental health to determine the best treatment plan.