Congenital Ovarian-Fallopian Tube Agenesis Predisposes to Premature Surgical Menopause: A Report of Two Cases

Conclusion: Two cases of unilateral ovarian and partial tubal agenesis predisposed the patients to early menopause by requiring removal of the contralateral ovary due to recurrent torsion or ovarian cancer. Upon discovery of congenital absence of an ovary during surgery, an effort should be made to preserve the functionality of the contralateral adnexa and uterus if fertility is desired. retroperitoneal. The patient was started on oral contraceptive pills, but two years later, her right lower quadrant pain recurred. Ultrasound and CT scans showed a large pelvic mass with no identification of the left ovary. The uterus and kidneys bilaterally were normal. During the second laparoscopy, the right ovary was found to be necrotic and torsed (Figure 1A) with blood in the pelvis, and a laparoscopic right salpingo-oophorectomy was performed. The left Fallopian tube again appeared blunted with a possible retroperitoneal rudimentary ovary (Figure 1B). After surgery, the patient reported hot flashes and amenorrhea, and was referred to the Reproductive Endocrinology office. Laboratory studies were consistent with menopause, including an FSH of 35 mIU/ml and an anti-Mullerian hormone level of < 0.3 ng/ml. She was started on vitamin D supplementation and combination estrogen plus progestin patch hormone therapy. She was counselled that she would require donor egg or adoption in the future if she desired children.