Katharina Rall1, Simone Eisenbeis2, Verena Henninger2, Melanie Henes2, Diethelm Wallwiener2, Michael Bonin3, Sara Brucker2. 1. University Hospital Tuebingen, Department of Obstetrics and Gynecology, Tuebingen, Germany. Electronic address: Katharina.Rall@med.uni-tuebingen.de. 2. University Hospital Tuebingen, Department of Obstetrics and Gynecology, Tuebingen, Germany. 3. University Hospital Tuebingen, Department of Medical Genetics, Microarray Facility, Tuebingen, Germany.
Abstract
STUDY OBJECTIVE: The Mayer-Rokitansky-Kuester-Hauser (MRKH) syndrome is characterized by vaginal and uterine aplasia in a 46,XX individual. Multiple abnormalities may be associated with MRKH syndrome, and it appears to overlap other syndromes. The aim of this study was to describe the spectrum of associated malformations and syndromes as well as abnormal karyotypic findings in a large cohort of 346 patients. DESIGN, SETTING, AND PARTICIPANTS: The study is a retrospective analysis of 346 MRKH patients treated in the University Hospital in Tuebingen between 1998 and 2013. MAIN OUTCOME MEASURES: The dataset was screened for typical associated malformations as well as atypical malformations and abnormal karyotypes. A complete review of the literature was included. RESULTS: Among our cohort of 346 patients, we found that 53.2% had MRKH type 1, 41.3% had MRKH type 2, and 5.5% had MURCS syndrome. The group with associated malformations included 57.6% renal, 44.4% skeletal, and 30.8% other malformations. Additionally, we found 2 cases of absent radius syndrome, 3 cases of anal atresia, and 1 patient with oculodentodigital dysplasia, and other atypical malformations. Abnormal karyotypes were found in 5 cases, and 39 siblings and 11 parents had known malformations. CONCLUSIONS: This study supports the hypothesis that the syndrome has a multifactorial pathogenesis. With the high numbers of associated malformations reported in this study, patients with MRKH syndrome should be regarded as having a complex syndrome. Molecular-genetic analyses in larger numbers of children after surrogacy, twin pregnancies, and familial cases may make it possible to obtain further information about the etiology of the syndrome.
STUDY OBJECTIVE: The Mayer-Rokitansky-Kuester-Hauser (MRKH) syndrome is characterized by vaginal and uterine aplasia in a 46,XX individual. Multiple abnormalities may be associated with MRKH syndrome, and it appears to overlap other syndromes. The aim of this study was to describe the spectrum of associated malformations and syndromes as well as abnormal karyotypic findings in a large cohort of 346 patients. DESIGN, SETTING, AND PARTICIPANTS: The study is a retrospective analysis of 346 MRKH patients treated in the University Hospital in Tuebingen between 1998 and 2013. MAIN OUTCOME MEASURES: The dataset was screened for typical associated malformations as well as atypical malformations and abnormal karyotypes. A complete review of the literature was included. RESULTS: Among our cohort of 346 patients, we found that 53.2% had MRKH type 1, 41.3% had MRKH type 2, and 5.5% had MURCS syndrome. The group with associated malformations included 57.6% renal, 44.4% skeletal, and 30.8% other malformations. Additionally, we found 2 cases of absent radius syndrome, 3 cases of anal atresia, and 1 patient with oculodentodigital dysplasia, and other atypical malformations. Abnormal karyotypes were found in 5 cases, and 39 siblings and 11 parents had known malformations. CONCLUSIONS: This study supports the hypothesis that the syndrome has a multifactorial pathogenesis. With the high numbers of associated malformations reported in this study, patients with MRKH syndrome should be regarded as having a complex syndrome. Molecular-genetic analyses in larger numbers of children after surrogacy, twin pregnancies, and familial cases may make it possible to obtain further information about the etiology of the syndrome.
Authors: H E Peters; B N Johnson; E A Ehli; D Micha; M O Verhoeven; G E Davies; J J M L Dekker; A Overbeek; M H van den Berg; E van Dulmen-den Broeder; F E van Leeuwen; V Mijatovic; D I Boomsma; C B Lambalk Journal: Hum Reprod Date: 2019-06-04 Impact factor: 6.918
Authors: Sara Yvonne Brucker; Leonie-Sophia Pösch; Joachim Graf; Alexander N Sokolov; Norbert Schaeffeler; Andrea Kronenthaler; Hanna Hiltner; Anke Wagner; Esther Ueding; Monika A Rieger; Dorit Schöller; Diana Stefanescu; Kristin Katharina Rall; Diethelm Wallwiener; Elisabeth Simoes Journal: BMC Womens Health Date: 2020-06-29 Impact factor: 2.809