At age 28, she stopped taking the pill. What followed was a decade of failed treatments, financial strain, and a pregnancy no one predicted.
The woman, now at the center of a published case report, had been born without a cervix or vagina — a combination of conditions that went undetected until 1999, when she was 16 and referred to a pediatric-adolescent gynecology clinic in the United Kingdom. Her symptom was straightforward: regular pelvic pain that tracked with a menstrual cycle, but no period. Doctors call the absence of menstruation amenorrhea. What they found behind it was far less routine.
A pelvic ultrasound and MRI showed she had a uterus, functioning ovaries, and healthy fallopian tubes — but no cervix and no vagina. A laparoscopy confirmed the findings. There was also no evidence of endometriosis. The diagnosis was cervical agenesis, the complete absence of a cervix at birth, a form of cervical atresia believed to affect between 1 in 100,000 and 1 in 80,000 births. Vaginal agenesis often accompanies it. One small study of 18 women with a missing or malformed cervix found vaginal agenesis in roughly 39% of cases, according to the report.
Rather than remove the uterus — an option the medical team considered — doctors performed a vaginoplasty after discussions with the girl and her family. The procedure created a vagina with a cervical opening connecting to the uterus. Her period started one month after surgery. She was placed on a cyclical contraceptive regimen, and the structural outcome held.
A decade of fertility treatment
When she and her partner decided to try for a child in 2010, the picture became more complicated. Hormone testing showed her egg count was lower than expected for her age. A pelvic MRI detected a small buildup of menstrual blood in the uterus, pointing to possible scar tissue obstructing the upper vagina. Doctors performed a corrective procedure, then attempted three rounds of intrauterine insemination — delivering her partner’s sperm directly into the uterus through a cannula. None succeeded.
The couple then moved to IVF. Eggs were retrieved, fertilized with the partner’s sperm, and the resulting embryos were placed into the uterus. Three rounds. All unsuccessful. The couple stopped treatment for financial reasons.
The unexpected outcome
Then, in 2022, more than a decade after she first sought fertility help, the woman conceived naturally. She gave birth to a son. The case report notes that natural conception is uncommon for women who have undergone surgery to address the absence of a cervix or vagina.
Her son’s existence sits at the intersection of surgical reconstruction, years of failed assisted reproduction, and an outcome that the available medical data would not have predicted.
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