Unilateral agenesis of the right ovary and Fallopian tube  in an infertile patient with a normal uterus

Ivana  Rudić Biljić Erski; Mladenko  Vasiljević; Snežana  Rakić; Sladjana  Mihajlović

doi:10.2298/VSP170213113R

Ivana Rudić Biljić Erski Clinic of Gynecology and Obstetrics “Narodni Front”, Belgrade, Serbia
Mladenko Vasiljević Clinic of Gynecology and Obstetrics “Narodni Front”, Belgrade, Serbia
Snežana Rakić Clinic of Gynecology and Obstetrics “Narodni Front”, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia
Sladjana Mihajlović Clinic of Gynecology and Obstetrics “Narodni Front”, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia

DOI: https://doi.org/10.2298/VSP170213113R

Keywords: congenital abnormalities;, diagnosis;, fallopian tubes;, infertility;, laparoscopy;, ovary.

Abstract

Introduction. Unilateral ovarian and Fallopian tube agenesis is an extremely rare anomaly that is usually associated with uterine and renal anomalies. This anomaly is usually incidentally detected during laparoscopy or laparotomy performed for other indications. We have reported a rare case of unilateral ovarian and Fallopian tube agenesis in an infertile patient with a normal uterus. Case report. A 34-year-old infertile patient was admitted to our clinic for laparoscopy and hysteroscopy, indicated for the right Fallopian tube occlusion and an endometrial polyp. The patient underwent laparoscopy and hysteroscopy. Unilateral right ovarian and Fallopian tube agenesis was diagnosed during laparoscopy. Upon exploration of peritoneal surfaces, omentum and intestinal serosa, neither ectopic nor remnant tissues of the ovary or Fallopian tube were found. Renal anomalies were not identified on the ultrasound examination. The hormone panel and karyotype were normal. Her partner’s semen analysis was normal. The patient conceived spontaneously one year later. Serial ultrasound examinations showed normal fetal intrauterine growth and development. The patient vaginally delivered a live, female newborn at 40 weeks’ gestation, weighing 3,350 grams, 53 cm long, with 9/10 Apgar scores at birth. The patient and her newborn were discharged home on the third postpartum day. Conclusion. Unilateral ovarian and Fallopian tube agenesis is rarely associated with a normal uterus. Laparoscopy is the gold standard in the diagnosis of ovarian and Fallopian tube agenesis. Unless other obstetric indications are present, this anomaly is not specific and it is not an indication for a Caesarean section, and vaginal delivery is a possibility at term pregnancy.

References

Sivanesaratnom V. Unexplained unilateral absence of ovary and fallopian tube. Eur J Obstet Gynecol Reprod Biol 1986; 22(1–2): 103–5.

Barsky M, Beaulieu AM, Sites CK. Congenital ovarian-fallopian tube agenesis predisposes to premature surgical menopause: A report of two cases. J Androl Gynaecol 2015; 3(1): 3.

Uckuyu A, Ozcimen EE, Sevincciftci FC. Unilateral congenital ovarian and partial tubal absence: Report of four cases with review of the literature. Fertil Steril 2009; 91(3): 936.e5–8.

Pabuccu E, Kahraman K, Taskın S, Atabekoglu C. Unilateral ab-sence of fallopian tube and ovary in an infertile patient. Fertil Steril 2011; 96(1): e55–7.

Sadler TW. Langman's medical embryology. 13th ed. Philadel-phia, Pennsylvania: Wolters Kluwer Health; 2015.

Stuti T, Suchitra J, Surinder S, Pragya Y. An incidental finding of unicornuate uterus with unilateral ovarian agenesis and ipsilat-eral twining of fallopian tubes during cesarean. JARMS 2015; 7(1): 11–3.

Chen B, Yang C, Sahebally Z, Jin H. Unilateral ovarian and Fal-lopian tube agensis in an infertile patient with a normal uterus. Exp Ther Med 2014; 8(3): 831–5.

Maurya NR, Gupta AS. A case of unilateral complete absence of fallopian tube and ovary. JPGO 2015; 3: 1.

Rastogi R, Gupta Y, Gupta B, Sinha P, Chaudhary M, Parashar S, et al. Unilateral agenesis of adnexa: A rare clinico-radiological condition. J Med Diagn Meth 2016; 5: 228.

Yerebasmaz N, Dilbaz B, Şengül Ö, Altınbaş S, Çakır L. Four cases with congenital unilateral absence of ovary and fallopian tube: Review of the literature. J Clin Anal Med 2016; 7(Suppl 3): 275–8.

Sukhadiya M, Grover SV. Unexplained unilateral absence of fallopian tube and ovary: A rare occurrence. J South Asian Feder Menopause Soc 2014; 2(1): 46–7.

Fruzzetti F, Bucci F, Perini D, Gadducci A. Unilateral adnexal agenesis and dermoid cyst: Fertility implications. Gynecol En-docrinol 2015; 31(6): 438–40.

Erkilinc S, Güzel AI, Doganay M, Özer I, Ümit C. Incidental unilateral tubal absence detected during cesarean section: Re-port of a case. Gynecol Obstet Reprod Med 2014; 20: 60–1.