Case sharing.
A female, 15 years and 7 months old, never had a period, ultrasound showed a uterus of 2.5X1.5cm, suggesting an infantile uterus. The local doctor told the parents that her uterus was too small and she could not have children in the future. …… The parents were so anxious that they did not sleep for several nights. The vagina is about 8 cm deep and the uterus is about 2.5 X 1 cm in size on anal examination.
cm in size.
1. What is infantile uterus? What is the difference between it and the primordial uterus?
Simply put, the primordial uterus is very small (the size of a soybean on anal examination) and has no cavity, but a solid myometrium with no endometrium; the infantile uterus has an endometrium. In other words, the primordial uterus cannot have menstruation, while the infantile uterus can have menstruation.
2. How can we identify an etiolated uterus or an infantile uterus?
In addition to the size of the uterus, it depends on whether she can have a period or not.
So how can we get menstruation?
Normally, menstruation is possible only when the endometrium has estrogen and progesterone. If the person has estrogen and progesterone in her body and does not get her period, consider that the endometrium is not functioning. If the person does not secrete estrogen and progesterone by herself, then we exogenously give her sufficient amount of estrogen and progesterone, and if she still does not get a period, it means that the uterus is not functional, and if she can get a period, it means that the uterus is functional.
3. Can’t I get pregnant if I have an infantile uterus?
As long as the uterus can have menstruation, or can have menstruation with medicine, it can bear pregnancy, and the size of the uterus does not matter.
Here is a story for you.
Once, a 26-year-old patient with primary amenorrhea came to see me. As soon as she saw me, she asked me, “Doctor, do you think I can still get pregnant?” It turned out that this patient had seen many gynecologists before she came to me, and all of them, without exception, said that her uterus was too small and that it was impossible to get pregnant. In order to answer her question, I had to clarify two issues: 1) whether the uterus was functional; and 2) why she was not getting her period.
So, I had her reproductive hormone 6 checked. When the results came out, I determined that she had low gonadotropin amenorrhea, a condition that can be treated with gonadotropin to promote ovulation; in addition, I gave her enough estrogen and progesterone, and as a result, she was able to get her period, indicating that her uterus was functioning.
So I answered her, “You should be able to get pregnant.” She was advised to do artificial cycle therapy with estrogen and progestin for a long time.
After a month or so, she came back for another visit and said she saw another gynecologist, and that doctor said, “Your uterus is so small, it’s impossible to get pregnant, and Professor He was just reassuring you.” She asked me, “Are you reassuring me, or can I really get pregnant?” I replied, “You should be able to get pregnant, you stick to the medicine now and come back to me when you are ready to get pregnant.” A year or so later, she came to me asking for fertility. I checked that her uterus was bigger than before, her fallopian tubes were open, and the male partner’s semen was normal, so I used gonadotropins to promote ovulation, and after one cycle of promoting ovulation this woman became pregnant.
The child mentioned at the beginning was not yet 16 years old, which is not the age for the diagnosis of primary amenorrhea, and the uterus of a child without menstruation is originally small.
If you encounter a similar situation, do not be anxious, but continue to observe. If you are over 16 years old and still do not have a period, consider having your reproductive hormones checked to determine the cause of amenorrhea.
Also give adequate amounts of estrogen and progesterone to determine the presence or absence of endometrium.
In conclusion.
The size of the uterus is not the basis for determining whether or not pregnancy can occur; the key is to see if the uterus functions accordingly.