Abstract
Background: As assisted reproductive technologies become increasingly available to patients, more women with Mullerian agenesis may undergo ovarian stimulation and oocyte retrieval to have genetically-related offspring. The risk of ovarian torsion is increased in patients utilizing assisted reproductive technologies compared to patients who do not undergo these treatments. Case: A 25-year-old G0 with Mayer-Rokitansky-Kuster-Hauser syndrome presented to the emergency room two days after oocyte retrieval with an acute abdomen. During laparoscopy, she was found to have torsion of her left ovary. Summary and Conclusion: As more young women with Mullerian agenesis present for fertility treatment, this anatomically unique patient cohort may be at an especially high risk for ovarian torsion. Physicians should recognize this risk and counsel their patients on this risk when discussing fertility options in patients with Mullerian agenesis.
Highlights
While women with Mayer-RokitanskyKuster-Hauser syndrome typically have congenital absence of the uterus, cervix and even part of the vagina, they do have functional ovaries.[1]
The risk of ovarian torsion is thought to be increased in adolescent women with longer utero-ovarian ligaments and laxity in ovarian support leading to increased mobility of the ovary.[5]
It may follow that having total absence of utero-ovarian ligaments and absence of the uterus creating more free space in the pelvis in patients with Müllerian agenesis compared to those patients with these structures, could increase the risk of adnexal torsion.[5,6]
Summary
While women with Mayer-RokitanskyKuster-Hauser syndrome typically have congenital absence of the uterus, cervix and even part of the vagina, they do have functional ovaries.[1]. Summary and Conclusion: As more young women with Müllerian agenesis present for fertility treatment, this anatomically unique patient cohort may be at an especially high risk for ovarian torsion.
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