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Becoming a Mother Despite Absence of Vagina (Mayer-Rokitansky-Küster-Hauser syndrome)

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Welcome to the YASH IVF blog. Today, we are going to talk about MRKHS syndrome, a rare but important condition that affects 1 in 5000 women world-wide.

MRKHS syndrome, also known as Mayer-Rokitansky-Küster-Hauser syndrome, is a genetic condition that affects the development of the female reproductive system. Fortunately, advances in medical & surgical technology can enable such women to have normal sex life and also become mothers through surrogacy, using the services of surrogate mothers, at IVF centers authorized for Surrogacy and which also have advanced reconstructive technology and trained surgeons to perform the complex reconstructive surgery required in such cases.

In this article let us answer some very basic & important  questions that every woman born with this affliction, and her family members, will want answered.

What causes MRKHS syndrome?

The cause of MRKHS syndrome is not well understood, but it is thought to be related to abnormal development of the embryonic Müllerian ducts, which are responsible for forming the female reproductive system.

While there is no cure for MRKHS syndrome, there are treatments available that can help women have a normal sex life and even become pregnant through surrogacy or other assisted reproductive technologies. One common treatment is surgical creation of a neovagina, which involves using skin grafts or tissue expanders to create a functional vagina.

What are the symptoms of MRKHS syndrome?

As the name indicates, it is a syndrome, it simply means symptoms of many origins. The symptoms mostly presented by patients are Primary amenorrhea and cyclic pelvic pain at puberty.

It can be followed by physical examination. If it suggest an absent or underdeveloped vagina, clinicians should consider the possibility of MRKH syndrome.

Once these conditions are suspected, imaging studies such as, Ultrasonography and MRI play a vital role which establish the degree of gynecologic and extra-gynecologic abnormalities, including renal or skeletal issues.

What should the family do if above symptoms are noticed? 

The women in the family, be it the mother or an elder sister, should be alert to any such anomaly in the youngster’s life. It is important for women with MRKHS syndrome to receive specialized care from a team of experts, including gynecologists, reproductive endocrinologists, and genetic counselors. These specialists can provide a comprehensive treatment plan tailored to each woman’s unique needs and goals.

If you or someone you know has been diagnosed with MRKHS syndrome, it is important to seek the support and care of a knowledgeable healthcare provider. With the right treatment, women with MRKHS syndrome can lead happy, healthy lives and even fulfill their dreams of starting a family.

Can a woman with MRKHS have normal intercourse? 

Women with  Mayer-Rokitansky-Küster-Hauser syndrome  are born without a uterus, cervix and upper vagina. Due to this condition, it may cause the vagina and uterus to be underdeveloped or absent, although external genitalia are normal. They may also have abnormalities in their kidneys, skeleton, and hearing. MRKHS syndrome is usually diagnosed when a young girl does not begin menstruating by age 16, or when a young woman is unable to have intercourse due to vaginal agenesis (absence of a vagina).

Fortunately, however, reconstructive surgery can give her a functional vagina and she can have normal intercourse.

Does this surgically  reconstructed vagina feel different to the partner?

No. After creation of a vagina using dilators or surgery, no one will know that you were born with an incomplete vagina.  The partner will not feel the difference.

What about the pregnancy in case of MRKH syndrome?

Women who have MRKH syndrome cannot naturally carry a pregnancy due to an underdeveloped or absent uterus. They can have a baby through surrogacy, where another woman carry the baby in her (womb).

Can she have a baby from her own eggs? 

This depends upon the condition of her ovaries. While some may have fully functional ovaries, others may not have a good ovarian function. In the latter case, they can develop embryos through donor eggs fertilized by the husband’s sperm. Those who have good ovarian function can have  their own eggs fertilised with their partner’s or donor sperm and can have a baby through surrogacy. It is done through In vitro Fertilization or IVF as it is commonly known (Test Tube Baby).

Pearls of wisdom for absent or underdeveloped vagina.

1. Be in touch with your body to understand it well as you are not the only one having this condition.

2. You are not born less as absence or underdeveloped vagina cannot define women.

3. Advances in medical science can enable you to have and enjoy a normal sex life

4. There are many different options around dilation and lengthening a vagina and the best guidance will be provided at our center at Yash IVF, Deccan.

5. Most of the time, women with MRKHS have ovaries, so can ovulate, may have cyclic abdomen pain

At Yash IVF we have seen & treated about 5 such cases in the last couple of years.

A few of these cases were diagnosed at Yash IVF while the others were referred for pregnancy.

Treatment pattern was divided into 2 phases.  – The first phase being enabling the woman to have a normal sex life. Comprehensive tests,  targetted therapy from our team of gynecologists, reproductive endocrinologists and genetic counselors, followed by reconstructive surgery for creating a vagina (vaginoplasty) makes this a reality.

The next phase is enabling parenthood for the couple. 

Some Ladies with MRKHS may have normal ovarian function and can ovulate. Others may not have functional ovaries.

Those with functional ovaries can undergo hormonal stimulation and their eggs can be harvested and fertilised by the sperm of their husbands. Those without a functional ovary can utilize the services of a donor. Eggs harvested from the donor’s ovaries can be fertilised by the husband of the MRKHS patient to generate healthy embryos.  Since the woman does not have a uterus, she can not bear her own child and so has to resort to surrogacy to make this a reality.  So  they can have a child through surrogacy by implanting embryos generated as above, into the womb of a surrogate mother.

We are a registered Surrogacy center and have our own ART Bank as well, in case donor eggs are required. This makes it easier for our patients as all the processes can be accomplished under a single umbrella.

Thank you for reading our blog on MRKHS syndrome. For more information about this condition or to schedule a consultation with one of our specialists, please contact YASH IVF.

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