Patients with Rokitansky Syndrome
Rokitansky syndrome is a complex developmental defect characterized by a complete or partial agenesis of vagina and uterus associated with normal external genitalia and gonads. Complete vaginal aplasia may be accompanied by rudimentary uterine cornu caused by premature termination of recanalization of the Müllerian ducts. Rokitansky syndrome is not generally transmitted as a prevalent genetic trait.
Gestational surrogacy that is absolutely legal and ethically recognized in Ukraine makes it feasible for the patients with Rokitansky syndrome to obtain their own genetic children. The first successful gestational surrogacy program was launched in Ukraine in 1992. A young woman whose ovaries were functioning normally, but who had not the uterus due to Rokitansky syndrome attended the Ukrainian clinic. Naturally, she could not conceive and maintain pregnancy on one’s own. After controlled ovarian stimulation, puncture of follicles and fertilization of the patient’s eggs with her husband’s sperm, the acquired embryos were transferred into the uterine cavity of 48-year-old mother of the patient. Three weeks later, the pregnancy was detected at ultrasonic. On July 1993, full term newborn girl first saw the world. The patient’s mother and, accordingly, the grandmother of a newborn girl did the role of a surrogate.
Gestational surrogacy might be a viable treatment option for patients with Rokitansky syndrome. Such patients ought to be well informed and supported so that they can have a family using their own genetic gametes. Until recently, the main interest in this matter revolved around reconstructive surgery, either laparoscopically or laparotomy. The various methods of construction of an artificial vagina were in the center of discussion too. Nowadays, new techniques of assisted conception have the possibility to allow patients suffering from Rokitansky syndrome to fulfil their fertility-seeking behaviors.
In the above retrospective example, we have presented the case happened in Ukraine, which confirmed the fact that the woman with Rokitansky syndrome have a good reproductive potential. We assume that the same patients will seek advice much earlier as IVF technology will be more prevalent and much more accessible. We did not discuss legalities concerning gestational surrogacy and related matters in detail. However, we feel that patients with Rokitansky syndrome would be well informed and supported, so they could have a happy family utilizing their own genetic gametes before their reproductive age is over.
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