Minor müllerian anomalies and oligomenorrhea in infertile women. A new syndrome.

Because a causal relationship was suspected between mild müllerian anomalies and oligomenorrhea-amenorrhea, the hysterosalpingograms of 134 consecutive infertility patients were reviewed. The review was blind with respect to menstrual pattern and other data. Mild müllerian anomalies of the uterus were exhibited in 21.6%; and among them, 58.6% had oligomenorrhea or amenorrhea. By comparison, oligomenorrhea or amenorrhea was found in only 19.6% of the remainder of infertility patients with normal uterine cavities (p less than 0.01). The association between mild müllerian anomalies and oligomenorrhea is further confirmed by the latter being idiopathic in 82.4% of these patients, in contrast to 30% of the group with normal uteri (p less than 0.01). Perusal of the literature shows that this relationship does not appear to have been substantiated previously, but occasionally it has been mentioned as a chance coincidence. On the basis of the patient's hormonal status and studies of the literature, the author advances the hypothesis of a defect in the steroid receptor proteins in the congenitally somewhat deformed uterus, in explanation of these patients' oligomenorrhea. The conclusion is that there must be a hitherto unheeded syndrome of fairly mild müllerian anomalies and eugonadotropic oligomenorrhea with demonstrable ovulation in infertile or low-fertility women. Perhaps, an increased tendency to abortion in the first or second trimester is another characteristic of this syndrome.