Evolving Health Frontiers in MRKH Syndrome: A Narrative Review

Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, or Mullerian agenesis, affects approximately 1 in 4,500 women, characterized by congenital absence of the uterus and upper two-thirds of the vagina. While patients possess normal secondary sexual characteristics and functional ovaries, they face unique challenges related to sexual function and reproductive potential. This review explores two rapidly evolving aspects mullerian agenesis care: non-surgical vaginal creation methods and fertility preservation strategies. Progressive vaginal dilation remains the gold standard for neovagina creation, with emerging devices and digital health tools enhancing home-based therapy outcomes. On the fertility front, options such as oocyte cryopreservation, gestational surrogacy, and the experimental yet promising uterine transplantation are reshaping possibilities for biological motherhood. This review emphasizes the importance of patient-centred approaches, technological integration, and ethical considerations in advancing care for individuals with Mayer-Rokitansky-Küster-Hauser syndrome.