rospedРоссийский педиатрический журнал имени М.Я. СтуденикинаM.Ya. Studenikin Russian Pediatric JournalФГАУ «НМИЦ здоровья детей» Минздрава России10.46563/1560-9561-2021-24-1-56-60rosped-1225Research ArticleКЛИНИЧЕСКИЙ СЛУЧАЙCLINICAL CASEДИАГНОСТИКА И ЛЕЧЕНИЕ СИНДРОМА ГЕРЛИНА-ВЕРНЕРА-ВАНДЕРЛИХА У НОВОРОЖДЁННОЙDIAGNOSTICS AND TREATMENT OF HERLYN-WERNER-WUNDERLICH SYNDROME IN A NEWBORN GIRLhttps://orcid.org/0000-0002-1370-6876ХворостовИгорь НиколаевичKhvorostovIgor N.ikhvorostov@gmail.comСиницынАлексей ГеннадиевичSinitsynAleksey G.noemail@neicon.ruБердниковаАнастасия ВладимировнаBerdnikovaAnastasiya V.noemail@neicon.ruКлимоваМария ВладимировнаKlimovaMariya V.noemail@neicon.ruЯхонтоваМария АлександровнаYakhontovaMariya A.noemail@neicon.ruФГБОУ ВО «Волгоградский государственный медицинский университет» Минздрава РоссииVolgograd State Medical University2021140120252415660Copyright © Хворостов И.Н., Синицын А.Г., Бердникова А.В., Климова М.В., Яхонтова М.А., 20252025Хворостов И.Н., Синицын А.Г., Бердникова А.В., Климова М.В., Яхонтова М.А.Khvorostov I.N., Sinitsyn A.G., Berdnikova A.V., Klimova M.V., Yakhontova M.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rosped.ru/jour/article/view/1225

Синдром Герлина-Вернера-Вандерлиха относится к сложным порокам развития мюллеровых протоков, включающим удвоение матки, атрезию одной из половин влагалища и агенезию почки с ипсилатеральной стороны, чаще справа. На первом этапе лечения обоснованным вмешательством считается вскрытие перегородки гемивагины чрезвлагалищным доступом под визуальным контролем или с использованием вагиноскопии. В нашем случае определён редкий вариант порока, поскольку продольная перегородка гемивагины не пролабировала через интроинус, что потребовало сложной диагностики и оперативного пособия у новорождённой. Значительный объем гидрометрокольпоса был связан с накоплением мочи из правой гипоплазированной почки с аномальным впадением эктопированного мочеточника в полость атрезированной вагины, что определило необходимость хирургического лечения по срочным показаниям. В связи с этим обязательным является биохимический анализ жидкости, полученной после дренирования гидрометрокольпоса, с определением концентрации мочевины, креатинина, общего белка и клеточного состава.

Herlin-Werner-Vanderlich syndrome refers to the Müllerian duct anomalies, including uterine didelphys, obstructed hemivagina, and ipsilateral renal agenesis. At the first stage of treatment, a reasonable intervention is opening the hemivaginal septum by extra-vaginal access under visual control or using vaginoscopy. We identified a rare variant of the defect identified, since the longitudinal septum of the hemivagina did not prolapse through the introinus, which required a complex diagnosis and surgical aid in the newborn. A significant volume of hydrometrocolpos was associated with the accumulation of urine from the right hypoplasmic kidney with an abnormal flow of the ectopic ureter into the cavity of the atresized vagina. It determined the need for surgical treatment for urgent indications. In this regard, a biochemical analysis of the fluid obtained after drainage of the hydrometrocolpos with the detection of the concentration of urea, creatinine, total protein, and cellular composition is mandatory.

новорождённыегидрокольпоссиндром Герлина-Вернера-Вандерлихааномалии мюллеровых протоковгипоплазия почкиудвоение маткиnewbornhydrocolposHerlin-Werner-Vanderlich syndromeMüllerian duct anomaliesrenal hypoplasiauterus didelphysReferencesThe American Fertility Society classifications of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies, müllerian anomalies and intrauterine adhesions. Fertil. Steril. 1988; 49(6): 944-55. https://doi.org/10.1016/s0015-0282(16)59942-7The American Fertility Society classifications of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies, müllerian anomalies and intrauterine adhesions. Fertil. Steril. 1988; 49(6): 944-55. https://doi.org/10.1016/s0015-0282(16)59942-7Wunderlich M. Unusual form of genital malformation with aplasia of the right kidney. Zentralbl. Gynakol. 1976; 98(9): 559-62. (in German)Wunderlich M. Unusual form of genital malformation with aplasia of the right kidney. Zentralbl. Gynakol. 1976; 98(9): 559-62. (in German)Smith N.A., Laufer M.R. Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome: management and follow-up. Fertil. Steril. 2007; 87(4): 918-22. https://doi.org/10.1016/j.fertnstert.2006.11.015Smith N.A., Laufer M.R. Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome: management and follow-up. Fertil. Steril. 2007; 87(4): 918-22. https://doi.org/10.1016/j.fertnstert.2006.11.015Herlyn U., Werner H. Simultaneous occurrence of an open Gartner-duct cyst, a homolateral aplasia of the kidney and a double uterus as a typical syndrome of abnormalities. Geburtshilfe Frauenheilkd. 1971; 31(4): 340-7. (in German)Herlyn U., Werner H. Simultaneous occurrence of an open Gartner-duct cyst, a homolateral aplasia of the kidney and a double uterus as a typical syndrome of abnormalities. Geburtshilfe Frauenheilkd. 1971; 31(4): 340-7. (in German)Vercellini P., Daguati R., Somigliana E., Viganò P., Lanzani A., Fedele L. Asymmetric lateral distribution of obstructed hemivagina and renal agenesis in women with uterus didelphys: institutional case series and a systematic literature review. Fertil. Steril. 2007; 87(4): 719-24. https://doi.org/10.1016/j.fertnstert.2007.01.173Vercellini P., Daguati R., Somigliana E., Viganò P., Lanzani A., Fedele L. Asymmetric lateral distribution of obstructed hemivagina and renal agenesis in women with uterus didelphys: institutional case series and a systematic literature review. Fertil. Steril. 2007; 87(4): 719-24. https://doi.org/10.1016/j.fertnstert.2007.01.173Orazi C., Lucchetti M.C., Schingo P.M., Marchetti P., Ferro F. Herlyn-Werner-Wunderlich syndrome: uterus didelphys, blind hemivagina and ipsilateral renal agenesis. Sonographic and MR findings in 11 cases. Pediatr. Radiol. 2007; 37(7): 657-65. https://doi.org/10.1007/s00247-007-0497-yOrazi C., Lucchetti M.C., Schingo P.M., Marchetti P., Ferro F. Herlyn-Werner-Wunderlich syndrome: uterus didelphys, blind hemivagina and ipsilateral renal agenesis. Sonographic and MR findings in 11 cases. Pediatr. Radiol. 2007; 37(7): 657-65. https://doi.org/10.1007/s00247-007-0497-yПисклаков А.В., Павленко Н.И., Пономарев В.И., Лысов А.В., Горлина А.Ю. Синдром Герлина-Вернера-Вандерлиха с эктопией мочеточника у девочки-подростка. Педиатрия. 2019; 98(5): 233-6. https://doi.org/10.24110/0031-403X-2019-98-5-233-236Писклаков А.В., Павленко Н.И., Пономарев В.И., Лысов А.В., Горлина А.Ю. Синдром Герлина-Вернера-Вандерлиха с эктопией мочеточника у девочки-подростка. Педиатрия. 2019; 98(5): 233-6. https://doi.org/10.24110/0031-403X-2019-98-5-233-236Шидаков И. Х., Калниязов Б. М. Гидрометрокольпос у новорождённого. Российский вестник детской хирургии, анестезиологии и реаниматологии. 2019; 9(4): 88-93. https://doi.org/10.30946/2219-4061-2019-9-4-88-9311Шидаков И. Х., Калниязов Б. М. Гидрометрокольпос у новорождённого. Российский вестник детской хирургии, анестезиологии и реаниматологии. 2019; 9(4): 88-93. https://doi.org/10.30946/2219-4061-2019-9-4-88-9311Epelman M., Dinan D., Gee M.S., Servaes S., Lee E.Y., Darge K. Müllerian duct and related anomalies in children and adolescents. Magn. Reson. Imaging Clin. N. Am. 2013; 21(4): 773-89. https://doi.org/10.1016/j.mric.2013.04.011Epelman M., Dinan D., Gee M.S., Servaes S., Lee E.Y., Darge K. Müllerian duct and related anomalies in children and adolescents. Magn. Reson. Imaging Clin. N. Am. 2013; 21(4): 773-89. https://doi.org/10.1016/j.mric.2013.04.011Acién P., Acién M., Sánchez-Ferrer M. Complex malformations of the female genital tract. New types and revision of classification. Hum. Reprod. 2004; 19(10): 2377-84. https://doi.org/10.1093/humrep/deh423Acién P., Acién M., Sánchez-Ferrer M. Complex malformations of the female genital tract. New types and revision of classification. Hum. Reprod. 2004; 19(10): 2377-84. https://doi.org/10.1093/humrep/deh423Костюков К.В., Подуровская Ю.Л., Кучеров Ю.И., Гус А.И. Пренатальная диагностика синдрома обструкции одного из удвоенных влагалищ в сочетании с ипсилатеральной аномалией почки. Ультразвуковая и функциональная диагностика. 2011; (3): 78-83Костюков К.В., Подуровская Ю.Л., Кучеров Ю.И., Гус А.И. Пренатальная диагностика синдрома обструкции одного из удвоенных влагалищ в сочетании с ипсилатеральной аномалией почки. Ультразвуковая и функциональная диагностика. 2011; (3): 78-83Wu T.H., Wu T.T., Ng Y.Y., Ng S.C., Su P.H., Chen J.Y., et al. Herlyn-Werner-Wunderlich syndrome consisting of uterine didelphys, obstructed hemivagina and ipsilateral renal agenesis in a newborn. Pediatr. Neonatol. 2012; 53(1): 68-71. https://doi.org/10.1016/j.pedneo.2011.11.014Wu T.H., Wu T.T., Ng Y.Y., Ng S.C., Su P.H., Chen J.Y., et al. Herlyn-Werner-Wunderlich syndrome consisting of uterine didelphys, obstructed hemivagina and ipsilateral renal agenesis in a newborn. Pediatr. Neonatol. 2012; 53(1): 68-71. https://doi.org/10.1016/j.pedneo.2011.11.014Garge S., Bagga D., Acharya S.K., Yadav D.K., Khan T.R., Kumar R., et al. Herlyn-Weber-Wunderlich syndrome with ectopic ureter in prepubertal female. J. Indian Assoc. Pediatr. Surg. 2014; 19(2): 103-5. https://doi.org/10.4103/0971-9261.129607Garge S., Bagga D., Acharya S.K., Yadav D.K., Khan T.R., Kumar R., et al. Herlyn-Weber-Wunderlich syndrome with ectopic ureter in prepubertal female. J. Indian Assoc. Pediatr. Surg. 2014; 19(2): 103-5. https://doi.org/10.4103/0971-9261.129607Wang Z.J., Daldrup-Link H., Coakley F.V., Yeh B.M. Ectopic ureter associated with uterine didelphys and obstructed hemivagina: preoperative diagnosis by MRI. Pediatr. Radiol. 2010; 40(3): 358-60. https://doi.org/10.1007/s00247-009-1454-8Wang Z.J., Daldrup-Link H., Coakley F.V., Yeh B.M. Ectopic ureter associated with uterine didelphys and obstructed hemivagina: preoperative diagnosis by MRI. Pediatr. Radiol. 2010; 40(3): 358-60. https://doi.org/10.1007/s00247-009-1454-8Gholoum S., Puligandla P.S., Hui T., Su W., Quiros E., Laberge J.M. Management and outcome of patients with combined vaginal septum, bifid uterus, and ipsilateral renal agenesis (Herlyn-Werner-Wunderlich syndrome). J. Pediatr. Surg. 2006; 41(5): 987-92. https://doi.org/10.1016/j.jpedsurg.2006.01.021Gholoum S., Puligandla P.S., Hui T., Su W., Quiros E., Laberge J.M. Management and outcome of patients with combined vaginal septum, bifid uterus, and ipsilateral renal agenesis (Herlyn-Werner-Wunderlich syndrome). J. Pediatr. Surg. 2006; 41(5): 987-92. https://doi.org/10.1016/j.jpedsurg.2006.01.021Wang J., Zhu L., Lang J., Liu Z., Sun D., Leng J., et al. Clinical characteristics and treatment of Herlyn-Werner-Wunderlich syndrome. Arch. Gynecol. Obstet. 2014; 290(5): 947-50. https://doi.org/10.1007/s00404-014-3286-5Wang J., Zhu L., Lang J., Liu Z., Sun D., Leng J., et al. Clinical characteristics and treatment of Herlyn-Werner-Wunderlich syndrome. Arch. Gynecol. Obstet. 2014; 290(5): 947-50. https://doi.org/10.1007/s00404-014-3286-5Capito C., Echaieb A., Lortat-Jacob S. Pitfalls in the diagnosis and management of obstructive uterovaginal duplication: A series of 32 cases. Pediatrics. 2008; 122(4): 891-7. https://doi.org/10.1542/peds.2008-0219Capito C., Echaieb A., Lortat-Jacob S. Pitfalls in the diagnosis and management of obstructive uterovaginal duplication: A series of 32 cases. Pediatrics. 2008; 122(4): 891-7. https://doi.org/10.1542/peds.2008-0219Smith N.A., Laufer M.R. Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome: management and follow-up. Fertil. Steril. 2007; 87(4): 918-22. https://doi.org/10.1016/j.fertnstert.2006.11.015Smith N.A., Laufer M.R. Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome: management and follow-up. Fertil. Steril. 2007; 87(4): 918-22. https://doi.org/10.1016/j.fertnstert.2006.11.015The American Fertility Society classifications of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies, müllerian anomalies and intrauterine adhesions. Fertil. Steril. 1988; 49(6): 944-55. https://doi.org/10.1016/s0015-0282(16)59942-7The American Fertility Society classifications of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies, müllerian anomalies and intrauterine adhesions. Fertil. Steril. 1988; 49(6): 944-55. https://doi.org/10.1016/s0015-0282(16)59942-7Wunderlich M. Unusual form of genital malformation with aplasia of the right kidney. Zentralbl. Gynakol. 1976; 98(9): 559-62. (in German)Wunderlich M. Unusual form of genital malformation with aplasia of the right kidney. Zentralbl. Gynakol. 1976; 98(9): 559-62. (in German)Smith N.A., Laufer M.R. Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome: management and follow-up. Fertil. Steril. 2007; 87(4): 918-22. https://doi.org/10.1016/j.fertnstert.2006.11.015Smith N.A., Laufer M.R. Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome: management and follow-up. Fertil. Steril. 2007; 87(4): 918-22. https://doi.org/10.1016/j.fertnstert.2006.11.015Herlyn U., Werner H. Simultaneous occurrence of an open Gartner-duct cyst, a homolateral aplasia of the kidney and a double uterus as a typical syndrome of abnormalities. Geburtshilfe Frauenheilkd. 1971; 31(4): 340-7. (in German)Herlyn U., Werner H. Simultaneous occurrence of an open Gartner-duct cyst, a homolateral aplasia of the kidney and a double uterus as a typical syndrome of abnormalities. Geburtshilfe Frauenheilkd. 1971; 31(4): 340-7. (in German)Vercellini P., Daguati R., Somigliana E., Viganò P., Lanzani A., Fedele L. Asymmetric lateral distribution of obstructed hemivagina and renal agenesis in women with uterus didelphys: institutional case series and a systematic literature review. Fertil. Steril. 2007; 87(4): 719-24. https://doi.org/10.1016/j.fertnstert.2007.01.173Vercellini P., Daguati R., Somigliana E., Viganò P., Lanzani A., Fedele L. Asymmetric lateral distribution of obstructed hemivagina and renal agenesis in women with uterus didelphys: institutional case series and a systematic literature review. Fertil. Steril. 2007; 87(4): 719-24. https://doi.org/10.1016/j.fertnstert.2007.01.173Orazi C., Lucchetti M.C., Schingo P.M., Marchetti P., Ferro F. Herlyn-Werner-Wunderlich syndrome: uterus didelphys, blind hemivagina and ipsilateral renal agenesis. Sonographic and MR findings in 11 cases. Pediatr. Radiol. 2007; 37(7): 657-65. https://doi.org/10.1007/s00247-007-0497-yOrazi C., Lucchetti M.C., Schingo P.M., Marchetti P., Ferro F. Herlyn-Werner-Wunderlich syndrome: uterus didelphys, blind hemivagina and ipsilateral renal agenesis. Sonographic and MR findings in 11 cases. Pediatr. Radiol. 2007; 37(7): 657-65. https://doi.org/10.1007/s00247-007-0497-yПисклаков А.В., Павленко Н.И., Пономарев В.И., Лысов А.В., Горлина А.Ю. Синдром Герлина-Вернера-Вандерлиха с эктопией мочеточника у девочки-подростка. Педиатрия. 2019; 98(5): 233-6. https://doi.org/10.24110/0031-403X-2019-98-5-233-236Писклаков А.В., Павленко Н.И., Пономарев В.И., Лысов А.В., Горлина А.Ю. Синдром Герлина-Вернера-Вандерлиха с эктопией мочеточника у девочки-подростка. Педиатрия. 2019; 98(5): 233-6. https://doi.org/10.24110/0031-403X-2019-98-5-233-236Шидаков И. Х., Калниязов Б. М. Гидрометрокольпос у новорождённого. Российский вестник детской хирургии, анестезиологии и реаниматологии. 2019; 9(4): 88-93. https://doi.org/10.30946/2219-4061-2019-9-4-88-9311Шидаков И. Х., Калниязов Б. М. Гидрометрокольпос у новорождённого. Российский вестник детской хирургии, анестезиологии и реаниматологии. 2019; 9(4): 88-93. https://doi.org/10.30946/2219-4061-2019-9-4-88-9311Epelman M., Dinan D., Gee M.S., Servaes S., Lee E.Y., Darge K. Müllerian duct and related anomalies in children and adolescents. Magn. Reson. Imaging Clin. N. Am. 2013; 21(4): 773-89. https://doi.org/10.1016/j.mric.2013.04.011Epelman M., Dinan D., Gee M.S., Servaes S., Lee E.Y., Darge K. Müllerian duct and related anomalies in children and adolescents. Magn. Reson. Imaging Clin. N. Am. 2013; 21(4): 773-89. https://doi.org/10.1016/j.mric.2013.04.011Acién P., Acién M., Sánchez-Ferrer M. Complex malformations of the female genital tract. New types and revision of classification. Hum. Reprod. 2004; 19(10): 2377-84. https://doi.org/10.1093/humrep/deh423Acién P., Acién M., Sánchez-Ferrer M. Complex malformations of the female genital tract. New types and revision of classification. Hum. Reprod. 2004; 19(10): 2377-84. https://doi.org/10.1093/humrep/deh423Костюков К.В., Подуровская Ю.Л., Кучеров Ю.И., Гус А.И. Пренатальная диагностика синдрома обструкции одного из удвоенных влагалищ в сочетании с ипсилатеральной аномалией почки. Ультразвуковая и функциональная диагностика. 2011; (3): 78-83Костюков К.В., Подуровская Ю.Л., Кучеров Ю.И., Гус А.И. Пренатальная диагностика синдрома обструкции одного из удвоенных влагалищ в сочетании с ипсилатеральной аномалией почки. Ультразвуковая и функциональная диагностика. 2011; (3): 78-83Wu T.H., Wu T.T., Ng Y.Y., Ng S.C., Su P.H., Chen J.Y., et al. Herlyn-Werner-Wunderlich syndrome consisting of uterine didelphys, obstructed hemivagina and ipsilateral renal agenesis in a newborn. Pediatr. Neonatol. 2012; 53(1): 68-71. https://doi.org/10.1016/j.pedneo.2011.11.014Wu T.H., Wu T.T., Ng Y.Y., Ng S.C., Su P.H., Chen J.Y., et al. Herlyn-Werner-Wunderlich syndrome consisting of uterine didelphys, obstructed hemivagina and ipsilateral renal agenesis in a newborn. Pediatr. Neonatol. 2012; 53(1): 68-71. https://doi.org/10.1016/j.pedneo.2011.11.014Garge S., Bagga D., Acharya S.K., Yadav D.K., Khan T.R., Kumar R., et al. Herlyn-Weber-Wunderlich syndrome with ectopic ureter in prepubertal female. J. Indian Assoc. Pediatr. Surg. 2014; 19(2): 103-5. https://doi.org/10.4103/0971-9261.129607Garge S., Bagga D., Acharya S.K., Yadav D.K., Khan T.R., Kumar R., et al. Herlyn-Weber-Wunderlich syndrome with ectopic ureter in prepubertal female. J. Indian Assoc. Pediatr. Surg. 2014; 19(2): 103-5. https://doi.org/10.4103/0971-9261.129607Wang Z.J., Daldrup-Link H., Coakley F.V., Yeh B.M. Ectopic ureter associated with uterine didelphys and obstructed hemivagina: preoperative diagnosis by MRI. Pediatr. Radiol. 2010; 40(3): 358-60. https://doi.org/10.1007/s00247-009-1454-8Wang Z.J., Daldrup-Link H., Coakley F.V., Yeh B.M. Ectopic ureter associated with uterine didelphys and obstructed hemivagina: preoperative diagnosis by MRI. Pediatr. Radiol. 2010; 40(3): 358-60. https://doi.org/10.1007/s00247-009-1454-8Gholoum S., Puligandla P.S., Hui T., Su W., Quiros E., Laberge J.M. Management and outcome of patients with combined vaginal septum, bifid uterus, and ipsilateral renal agenesis (Herlyn-Werner-Wunderlich syndrome). J. Pediatr. Surg. 2006; 41(5): 987-92. https://doi.org/10.1016/j.jpedsurg.2006.01.021Gholoum S., Puligandla P.S., Hui T., Su W., Quiros E., Laberge J.M. Management and outcome of patients with combined vaginal septum, bifid uterus, and ipsilateral renal agenesis (Herlyn-Werner-Wunderlich syndrome). J. Pediatr. Surg. 2006; 41(5): 987-92. https://doi.org/10.1016/j.jpedsurg.2006.01.021Wang J., Zhu L., Lang J., Liu Z., Sun D., Leng J., et al. Clinical characteristics and treatment of Herlyn-Werner-Wunderlich syndrome. Arch. Gynecol. Obstet. 2014; 290(5): 947-50. https://doi.org/10.1007/s00404-014-3286-5Wang J., Zhu L., Lang J., Liu Z., Sun D., Leng J., et al. Clinical characteristics and treatment of Herlyn-Werner-Wunderlich syndrome. Arch. Gynecol. Obstet. 2014; 290(5): 947-50. https://doi.org/10.1007/s00404-014-3286-5Capito C., Echaieb A., Lortat-Jacob S. Pitfalls in the diagnosis and management of obstructive uterovaginal duplication: A series of 32 cases. Pediatrics. 2008; 122(4): 891-7. https://doi.org/10.1542/peds.2008-0219Capito C., Echaieb A., Lortat-Jacob S. Pitfalls in the diagnosis and management of obstructive uterovaginal duplication: A series of 32 cases. Pediatrics. 2008; 122(4): 891-7. https://doi.org/10.1542/peds.2008-0219Smith N.A., Laufer M.R. Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome: management and follow-up. Fertil. Steril. 2007; 87(4): 918-22. https://doi.org/10.1016/j.fertnstert.2006.11.015Smith N.A., Laufer M.R. Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome: management and follow-up. Fertil. Steril. 2007; 87(4): 918-22. https://doi.org/10.1016/j.fertnstert.2006.11.015

The authors declare that there are no conflicts of interest present.