title: Primary infertility associated with isolated cervical collecting diverticulum.
abstract: OBJECTIVE
  To describe a previously unreported isolated congenital cervical diverticulum and its gynecologic, reproductive, and obstetrical implications.
  
  
  METHODS
  Case report.
  
  
  METHODS
  A university hospital.
  
  
  METHODS
  A 31-year-old woman presenting with menometrorrhagia and primary infertility. Investigation revealed an isolated collecting cervical diverticulum causing prolonged postmenstrual spotting, possibly interfering with sperm capacitation and access to the uterine cavity.
  
  
  METHODS
  The examination included hysterosalpingography and magnetic resonance imaging. The combined hysteroscopy and laparoscopy revealed a 5 x 5 cm cervical diverticulum, around 1 cm from the external cervical os, leading to a short cervical canal connected to a normal uterine cavity. The patient achieved a pregnancy after controlled ovarian hyperstimulation and ultrasonographically guided intrauterine insemination. MAIN OTUCOME MEASURE(S): Pregnancy and obstetrical outcome.
  
  
  RESULTS
  Extensive evaluation revealed the patient's condition to be a previously undescribed congenital cervical anomaly. The patient's infertility was corrected by ovulation induction and sonographically guided intrauterine insemination, which resulted in a twin pregnancy. After 27 weeks of gestation, preterm labor complicated the delivery.
  
  
  CONCLUSIONS
  The diagnosis and management of this unusual congenital cervical diverticulum present a particular challenge, as this congenital abnormality has not been previously described or reported.
authors.affiliation: Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon. mike@aub.edu.lb
authors.forename: Muhieddine
authors.initials: M
authors.lastname: Seoud
authors.forename: Johnny
authors.initials: J
authors.lastname: Awwad
authors.forename: Abdallah
authors.initials: A
authors.lastname: Adra
authors.forename: Ihab
authors.initials: I
authors.lastname: Usta
authors.forename: Ali
authors.initials: A
authors.lastname: Khalil
authors.forename: Anwar
authors.initials: A
authors.lastname: Nassar
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000002:abnormalities; D004240:Diverticulum / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D007047:Hysterosalpingography; D007247:Infertility, Female / Q000209:etiology*; D011247:Pregnancy; D002577:Uterine Cervical Diseases / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery