Successful pregnancy after reconstructive surgery for a woman with complete cervical and vaginal agenesis - a case report and literature review.
Jennifer A Tamblyn, Syed Salahuddin, Lara C Morley et al.
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Case in brief
A 16-year-old girl presented with cyclical pelvic pain and primary amenorrhoea and was diagnosed with complete cervical and vaginal agenesis. Vaginoplasty and direct uterovaginal anastomosis were followed by regular, pain-free menstruation and later uncomplicated sexual intercourse. After 10 years of primary infertility and unsuccessful assisted reproduction treatment, she conceived naturally and delivered a healthy male infant by caesarean section at term.
What made this case unusual
Natural conception and term birth occurred after a decade of infertility and unsuccessful assisted reproduction following reconstructive surgery for complete cervical and vaginal agenesis.
Diagnostic / clinical pearl
Cyclical pelvic pain with primary amenorrhoea can signal an obstructive congenital anomaly; this case also shows that fertility outcomes after uterine reconstruction may be complex, warranting individualised multidisciplinary care.