Primary infertility associated with isolated cervical collecting diverticulum.
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.
Seoud
Muhieddine
M
Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon. mike@aub.edu.lb
Awwad
Johnny
J
Adra
Abdallah
A
Usta
Ihab
I
Khalil
Ali
A
Nassar
Anwar
A
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