Fertility options in Mayer-Rokitansky-Küster-Hauser syndrome

Abstract

Fertility options in Mayer-Rokitansky-Küster-Hauser syndrome Francesco Fedele1, *, Alessandro Bulfoni2 , Stefano Salvatore1 , Massimo Candiani1 1Obstetrics and Gynaecology Department, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy 2Department of Gynaecology, Division of Obstetrics and Gynaecology, IRCCS Humanitas Clinical and Research Center, San Pio X, 20089 Milan, Italy *Correspondence: francesco.fedele123@gmail.com (Francesco Fedele) DOI:10.31083/j.ceog.2021.03.2442 This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/). Submitted: 31 December 2020 Revised: 16 February 2021 Accepted: 24 February 2021 Published: 15 June 2021 Background: The Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is the most common cause of uterine aplasia, with a worldwide frequency of 1 in 4500 females. Although abundant literature is present regarding the different available methods for creating a neovagina in MRKH syndrome, the attention dedicated to these women's reproductive potential remains insufficient. Methods: Online searches were carried out in PubMed database during November and December 2020. The search included a combination of the various terms (e.g., MRKH, vaginoplasty, uterus transplantation, infertility treatment, gestational surrogacy, etc.). The following inclusion criteria were used: (1) The articles should be written in English or French language. (2) The article should have been published by an official scientific organization. Results: Until few years ago, the only option for women with MRKH syndrome was legal adoption, now gestational surrogacy (GS) and uterine transplantation (UTx) have become new fertility options available to these patients. Discussion: GS is officially recognized in several countries and widely practiced. On the other hand, UTx, although the great recent technical improvements, is far from being an option for all women with MRKH syndrome secondary to its complexity and the necessary immunologic therapies. Keywords Mayer-Rokitansky-Küster-Hauser syndrome; Assisted reproductive technology; Gestational surrogacy; Uterus transplantation