Bilateral ovarian agenesis and the presence of the testis-specific protein 1-Y-linked gene: two new features of Mayer-Rokitansky-Küster-hauser syndrome

Abstract

Objective To describe the clinical and laboratory features of Mayer-Rokitansky-Küster-Hauser syndrome (MRKH) and to provide evidence for its etiology. Design Case report. Setting General hospital. Patient(s) Six consecutive cases of MRKH over a period of 12 months. Intervention(s) Endocrine evaluation was performed. Genital system abnormalities were studied by pelvic ultrasound, magnetic resonance imaging, and laparoscopy; associated congenital anomalies by bone studies and intravenous pyelogram; and presence of Y chromosome material by karyotype and polymerase chain reaction (PCR and nested PCR). Main outcome measure(s) Clinical and laboratory features of MRKH and presence of Y chromosome genes. Result(s) Endocrine evaluation was normal in five patients. One woman revealed hypergonadotropic hypogonadism due to bilateral absence of gonads. Four patients had symmetric (type A) and two had asymmetric uterine remnants and fallopian tubes (type B). Renal and skeletal malformations were present in both types of MRKH. Karyotype was 46,XX in all patients. Although PCR was negative, nested PCR revealed the testis specific protein 1-Y-linked (TSPY) gene in two women. Conclusion(s) Skeletal and renal malformations may be present in both MRKH subtypes. Gonadal absence may coexist with the syndrome. This is the first report that detects Y-chromosome genes in patients with MRKH.