Diminished ovarian reserve and ectopic ovaries in patients with Mayer-Rokitansky-Küster-Hauser syndrome candidates for Uterus Transplantation: our experience

Background: Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a congenital disease characterized by variable degrees of utero-vaginal agenesis. A diminished ovarian reserve and ectopic ovaries are common in these patients. The objective of this study is to highlight the issues relating to assisted r...

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Main Authors: Basilio Pecorino, Giuseppe Scibilia, Placido Borzì, Maria Elena Vento, Pierfrancesco Veroux, Paolo Scollo
Format: Article
Language:English
Published: IMR Press 2021-08-01
Series:Clinical and Experimental Obstetrics & Gynecology
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Online Access:https://www.imrpress.com/journal/CEOG/48/4/10.31083/j.ceog4804143
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author Basilio Pecorino
Giuseppe Scibilia
Placido Borzì
Maria Elena Vento
Pierfrancesco Veroux
Paolo Scollo
author_facet Basilio Pecorino
Giuseppe Scibilia
Placido Borzì
Maria Elena Vento
Pierfrancesco Veroux
Paolo Scollo
author_sort Basilio Pecorino
collection DOAJ
description Background: Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a congenital disease characterized by variable degrees of utero-vaginal agenesis. A diminished ovarian reserve and ectopic ovaries are common in these patients. The objective of this study is to highlight the issues relating to assisted reproduction in patients with MRKH syndrome who are candidates for Uterus Transplantation and to describe alternative methods to the classic transvaginal oocyte retrieval. Methods: In Italy, the Research Project for Uterus Transplantation from brain-dead donor started on 14/06/2018 (n. 1438/CNT2018). The potential recipients underwent to clinical evaluation, laboratory and instrumental tests to achieve eligibility for transplantation, ovarian stimulation and oocytes retrieval at the Obstetrics and Gynecology Unit of the Cannizzaro Hospital of Catania (Italy). A retrospective analysis of all patients affected by MRKH syndrome who are candidates for uterus transplantation was performed in order to highlight the problems encountered in assisted reproduction due to poor ovarian reserve or extra-pelvic gonads. Results: 15 of 64 patients (23%) were excluded after the first visit due to the poor ovarian reserve and/or ectopic ovaries. A 27-years old patient with MRKH syndrome type 2, with extra-pelvic ovaries and good ovarian reserve underwent ultrasound-guided and laparoscopically assisted transvaginal and transabdominal oocyte pick-up, with total retrieval of 12 oocytes and no short or long-term complications. Conclusion: Laparoscopically assisted oocyte retrieval is a feasible technique that can overcome some limitations for inclusion on waiting list for Uterus Transplantation, such as ectopic ovaries.
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spelling doaj-art-038ab826736f4eb8a27d66813e50d8ed2025-08-20T02:03:19ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632021-08-0148490791210.31083/j.ceog4804143S0390-6663(21)00151-2Diminished ovarian reserve and ectopic ovaries in patients with Mayer-Rokitansky-Küster-Hauser syndrome candidates for Uterus Transplantation: our experienceBasilio Pecorino0Giuseppe Scibilia1Placido Borzì2Maria Elena Vento3Pierfrancesco Veroux4Paolo Scollo5Gynecology and Obstetrics Units, Maternal and Child Department, Cannizzaro Hospital, 95126 Catania, ItalyGynecology and Obstetrics Units, Maternal and Child Department, Cannizzaro Hospital, 95126 Catania, ItalyGynecology and Obstetrics Units, Maternal and Child Department, Cannizzaro Hospital, 95126 Catania, ItalyGynecology and Obstetrics Units, Maternal and Child Department, Cannizzaro Hospital, 95126 Catania, ItalyVascular Surgery and Organ Transplant Unit, Department of Medical and Surgical Sciences, University Hospital of Catania, 95123 Catania, ItalyGynecology and Obstetrics Units, Maternal and Child Department, Cannizzaro Hospital, 95126 Catania, ItalyBackground: Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a congenital disease characterized by variable degrees of utero-vaginal agenesis. A diminished ovarian reserve and ectopic ovaries are common in these patients. The objective of this study is to highlight the issues relating to assisted reproduction in patients with MRKH syndrome who are candidates for Uterus Transplantation and to describe alternative methods to the classic transvaginal oocyte retrieval. Methods: In Italy, the Research Project for Uterus Transplantation from brain-dead donor started on 14/06/2018 (n. 1438/CNT2018). The potential recipients underwent to clinical evaluation, laboratory and instrumental tests to achieve eligibility for transplantation, ovarian stimulation and oocytes retrieval at the Obstetrics and Gynecology Unit of the Cannizzaro Hospital of Catania (Italy). A retrospective analysis of all patients affected by MRKH syndrome who are candidates for uterus transplantation was performed in order to highlight the problems encountered in assisted reproduction due to poor ovarian reserve or extra-pelvic gonads. Results: 15 of 64 patients (23%) were excluded after the first visit due to the poor ovarian reserve and/or ectopic ovaries. A 27-years old patient with MRKH syndrome type 2, with extra-pelvic ovaries and good ovarian reserve underwent ultrasound-guided and laparoscopically assisted transvaginal and transabdominal oocyte pick-up, with total retrieval of 12 oocytes and no short or long-term complications. Conclusion: Laparoscopically assisted oocyte retrieval is a feasible technique that can overcome some limitations for inclusion on waiting list for Uterus Transplantation, such as ectopic ovaries.https://www.imrpress.com/journal/CEOG/48/4/10.31083/j.ceog4804143assisted reproductionlaparoscopymrkh syndromeoocyte pick-uputerus transplantation
spellingShingle Basilio Pecorino
Giuseppe Scibilia
Placido Borzì
Maria Elena Vento
Pierfrancesco Veroux
Paolo Scollo
Diminished ovarian reserve and ectopic ovaries in patients with Mayer-Rokitansky-Küster-Hauser syndrome candidates for Uterus Transplantation: our experience
Clinical and Experimental Obstetrics & Gynecology
assisted reproduction
laparoscopy
mrkh syndrome
oocyte pick-up
uterus transplantation
title Diminished ovarian reserve and ectopic ovaries in patients with Mayer-Rokitansky-Küster-Hauser syndrome candidates for Uterus Transplantation: our experience
title_full Diminished ovarian reserve and ectopic ovaries in patients with Mayer-Rokitansky-Küster-Hauser syndrome candidates for Uterus Transplantation: our experience
title_fullStr Diminished ovarian reserve and ectopic ovaries in patients with Mayer-Rokitansky-Küster-Hauser syndrome candidates for Uterus Transplantation: our experience
title_full_unstemmed Diminished ovarian reserve and ectopic ovaries in patients with Mayer-Rokitansky-Küster-Hauser syndrome candidates for Uterus Transplantation: our experience
title_short Diminished ovarian reserve and ectopic ovaries in patients with Mayer-Rokitansky-Küster-Hauser syndrome candidates for Uterus Transplantation: our experience
title_sort diminished ovarian reserve and ectopic ovaries in patients with mayer rokitansky kuster hauser syndrome candidates for uterus transplantation our experience
topic assisted reproduction
laparoscopy
mrkh syndrome
oocyte pick-up
uterus transplantation
url https://www.imrpress.com/journal/CEOG/48/4/10.31083/j.ceog4804143
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