MRI Imaging in Congenital Mullerian Duct Abnormalities Using New Classification from the American Society of Reproductive Medicine (ASRM MAC2021)

Abstract

Infertility is a very important issue. One of the causes of fertility disorders is due to congenital abnormalities in the Mullerian ducts. Congenital abnormalities of the Mullerian ducts are deviations from normal anatomy which include the uterus, fallopian tubes and or the upper two-thirds of the vagina originating from the paramesonephric. Mullerian duct anomalies originate from disturbances that occur in the three phases of uterine development starting from organogenesis, fusion, or septal resorption. MRI is an imaging modality with a fairly high level of accuracy, making it an ideal modality in the diagnosis of congenital Mullerian duct anomaly. With the ASRM MAC2021 classification system, it is easier to assess and analyze anatomical structures to diagnose congenital abnormalities of the Mullerian duct. This research is a retrospective descriptive study conducted at RSUD Dr. Soetomo Surabaya and has ethical license. There were 52 subjects in this study who were obtained from 2018-2021. In this study, the frequency according to the ASRM MAC2021 classification with the mullerian agenesis type was 36 patients (69%), cervical agenesis 4 patients (7.6%), unicornuate uterus 3 patients (5.7%), uterus didelphys 5 patients (9.6%), bicornuate uterus 1 patient (1.9%), septate uterus 1 patient (1.9%), longitudinal vaginal septum 1 patient (1.9%), transverse vaginal septum 1 patient(1.9%) %) and complex anomalies 0 patients (0%) from a total of 52 samples. To sharpen and facilitate the evaluation of congenital abnormalities, segmental descriptions are used in the results of the MRI examination.