Absence of endometrium as a cause of primary amenorrhea.

OBJECTIVE

To describe congenital endometrial absence.

DESIGN

Case report.

SETTING

University hospital.

PATIENT(S): A 32-year-old woman presented with primary amenorrhea and infertility. Hormone analysis, physical and gynecologic examinations, transvaginal ultrasonography, and karyotype analysis were normal.

INTERVENTION(S): Progesterone challenge test, laparoscopy, hysteroscopy were performed, and hysteroscopic biopsies were obtained from the uterine cavity.

MAIN OUTCOME MEASURE(S): Presence of endometrium, menstruation.

RESULT(S): The progesterone challenge test was negative. Laparoscopy revealed normal pelvic structures. Evaluation of biopsies from uterine cavity revealed absence of endometrium.

CONCLUSION(S): Endometrial absence is a differential diagnosis for primary amenorrhea; assessment of the uterine cavity and obtaining biopsy samples may help in diagnosis of suspected cases before they undergo assisted reproduction and can avoid unnecessary treatment.