Developmental anomalies of female genital organs in the practice of a reproductologist
DOI:
https://doi.org/10.37800/RM.3.2023.40-49Keywords:
Congenital malformations of the female genital tract, Muller anomalies, infertility, diagnosis and treatment of abnormalities of the female reproductive systemAbstract
Relevance: Congenital malformations of the female genital tract are defined as deviations from normal anatomy resulting from embryonal underdevelopment of the Muller or paramesonephric ducts. Depending on the type and degree of anatomical distortions, they are associated with health and problems with reproductive function. Because of their prevalence (4-7%) and clinical importance, a reliable classification system seems extremely useful for their treatment. Effective categorization provides more effective diagnosis and treatment and a better understanding of their pathogenesis and reproductive outcomes.
The study aimed to review reproductive cases with Mullerian duct anomalies from the literature sources and the authors’ experience.
Materials and Methods: The PUBMED, Web of Science, and EMBASE databases were searched for literary sources published from January 2018 to January 2023. Out of 42 articles found, 16 were included in this literary review. Combinations of the following keywords were used for the search: «Anomalies of the female reproductive system,» «female genital organs,» «infertility and Mullerian anomaly,» and «diagnosis and treatment Mullerian anomaly.»
Results: Women with congenital anomalies of the Mullerian ducts have unfavorable pregnancy outcomes in at least 25% of cases. However, a pregnancy in an abnormal uterus can proceed without incident and end with a normal birth. The general approach to a woman with a Mullerian duct anomaly has improved over the years.
The emergence of assisted reproductive technologies (ART) enabled many patients with obstructive Mullerian duct anomalies to successfully conceive a child. In-vitro fertilization gives a chance for pregnancy to patients with a history of adhesions and salpingectomy due to retrograde menstruation, endometriosis, and adhesive disease. In the case of cervical agenesis, pregnancy can be achieved through transmyometrial embryo transfer.
Conclusion: A practicing reproductologist should be proficient in scientifically based methods of treating female reproductive system congenital anomalies. The growing success of ART is allowing infertile couples to procreate. Considering the most common anomalies and reproductive consequences for female patients, we believe infertility specialists can better advise their patients with congenital anomalies regarding family planning options and a favorable course of pregnancy.
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