Radiological Approach of Uterine Agenesis caused by Mularian Duct Malformation

Abstract

Background: Müllerian duct anomalies (MDAs) are a group of congenital malformations affecting the female reproductive tract, leading to significant reproductive challenges. Uterine agenesis, particularly in the form of Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, is one of the most severe forms, causing primary amenorrhea and infertility. Imaging plays a crucial role in diagnosis and classification of these anomalies.

Objective: The purpose of the present study was to evaluate the radiological approach in diagnosing uterine agenesis caused by Müllerian duct malformations.

Methodology: This hospital-based observational study conducted form February 2024 to January 2025 included 65 patients diagnosed with uterine agenesis caused by MDAs. Radiological evaluations with ultrasound and magnetic resonance imaging (MRI) were conducted, with additional assessments through
hysterosalpingography and three-dimensional ultrasound where necessary. Descriptive statistics were used to analyze the clinical and radiological findings.

Results: The mean age of participants was 22.4±3.8 years. Primary amenorrhea was the most common clinical presentation (69.23%), followed by pelvic pain (15.38%) and infertility (13.85%). Uterine agenesis was the most frequent radiological finding (60%), with 40% of cases also showing associated renal anomalies. Class I Müllerian anomalies (hypoplasia/aplasia) were the most common (60%). Surgical success was achieved in 83.08% of cases, and 30.77% of patients who pursued fertility treatments achieved pregnancy. Psychological support improved the psychosocial outcomes in 75.38% of patients.

Conclusion: Radiological imaging, particularly ultrasound and MRI, is essential for the accurate diagnosis and management of uterine agenesis and other Müllerian duct anomalies.

Journal of Monno Medical College December, 2025;11(2):102-106