A woman born without a vagina or cervix managed to get pregnant naturally and give birth to a healthy child after years of fighting total cervical agenesis.
According to one case, the patient was referred in 1999, as a teenager, to a pediatric and adolescent gynecology consultation due to primary amenorrhea (absence of menstruation) despite having pelvic pain with a pattern compatible with regular menstrual cycles.
Imaging tests, including pelvic ultrasound and MRI, showed that the patient had a uterus, but no cervix or vagina. The diagnosis was then confirmed by laparoscopy, which also revealed healthy ovaries and fallopian tubes, with no signs of endometriosis.
Doctors identified the case as agenesia cervical totala rare form of cervical atresia, a congenital malformation estimated to occur in approximately one case in every 80,000 to 100,000 births. It may be accompanied by vaginal agenesis, as happened in this patient, according to .
In the first phase, the teenager started taking oral contraceptives continuously to suppress menstruation and avoid accumulation of menstrual blood. The team considered several surgical approaches, including removal of the uterus, but decided to proceed with a fertility-sparing solution. A vaginoplasty was performed, during which surgeons created a vagina and cervical opening that would allow connection to the uterus. After the operation, the patient resumed a cyclical pill regimen and began menstruating about a month later.
Years later, in 2010, at the age of 28, she stopped taking contraception to try to get pregnant with her partner. After a year without success, she turned to fertility specialists. The exams indicated an ovarian reserve below average for her age and also suggested the existence of scar tissue partially obstructing the upper part of the vagina. Doctors tried to correct the structural problem and performed three cycles of intrauterine insemination, without success. They followed three failed IVF attemptsinterrupted for personal financial reasons.
The surprising outcome came in 2022, eight years after the last fertility treatment: the woman became pregnant naturally. The birth, by scheduled cesarean section, took place on his 40th birthday: a healthy boy came into the world.
The case is considered an authentic medical miracle. In a systematic review of 121 patients undergoing similar interventions, only six managed to become pregnant naturally.
