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Surgical correction of rare Müllerian anomalies and spontaneous pregnancies: a case report.

Ganesh A, Gupta NJ, Chakravarty B

School of Medical Science and Technology, Indian Institute of Technology, Kharagpur, India. asha@smst.iitkgp.ernet.in

OBJECTIVE: To surgically reconstruct rare Müllerian duct anomalies with varying degrees of bladder exstrophy and congenital absence of ampullary portion of fallopian tube. DESIGN: Case report. SETTING: Institute of Reproductive Medicine, Salt Lake, Kolkata, India. PATIENT(S): Two cases of anteriorly displaced vagina with stenotic introitus, divergent pubic rami, and varying degrees of bladder exstrophy (group A) and three cases of congenital absence of ampullary portion of the fallopian tube with intact but blind fimbria attached to mesoovarium (group B). INTERVENTION(S): Introitoplasty and tubal anastomosis were performed for groups A and B, respectively. MAIN OUTCOME MEASURE(S): Description and treatment of two types of patients with rare Müllerian anomalies. RESULT(S): Three spontaneous pregnancies and viable deliveries, two in group A and one in group B, were achieved after surgical reconstruction. CONCLUSION(S): Assisted reproductive technologies usually provide a solution to infertility in rare Müllerian anomalies; reconstructive surgical procedures specific to the type of anatomical defect may also be considered for spontaneous pregnancy with viable deliveries.

Published 11 March 2008 in Fertil Steril, 89(3): 723.e13-6.
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