Surgical correction of rare Müllerian anomalies and spontaneous pregnancies: a case report  Ashalatha Ganesh, M.B.B.S., M.M.S.T., Nalini J. Gupta, Ph.D., Baidyanath Chakravarty, M.D., F.R.C.O.G.  Fertility and Sterility  Volume 89, Issue 3, Pages 723.e13-723.e16 (March 2008) DOI: 10.1016/j.fertnstert.2007.04.003 Copyright © 2008 American Society for Reproductive Medicine Terms and Conditions

Figure 1 (A) A 17-year-old girl with divergent labia, mons pubis, pubic rami, and bifid clitoris. The stenotic introitus is anteriorly displaced in the mons pubis region. (B) Introitoplasty is done by dissecting the anteriorly displaced vaginal tube from the surrounding tissue. (C) The perineal muscles and skin are divided in the midline approximately 2.5 cm short of the anterior margin of the anal canal. (D) The dissected vaginal wall is united by interrupted sutures with the perineal skin posteriorly and with the available tissue laterally and anteriorly. Fertility and Sterility 2008 89, 723.e13-723.e16DOI: (10.1016/j.fertnstert.2007.04.003) Copyright © 2008 American Society for Reproductive Medicine Terms and Conditions

Figure 2 (A) A 19-year-old girl with minimal grade of urethral exstrophy, anteriorly displaced stenotic introitus with divergent labia, mons pubis, pubic rami, and totally deficient abdominal muscles. (B) Posterior vaginal mucous membrane dissected upward and bisected posteriorly. The perineal muscles and skin are divided in the midline approximately 2.5 cm short of the anterior margin of the anal canal. (C) The bisected vaginal mucous membrane is united with the perineal skin. Fertility and Sterility 2008 89, 723.e13-723.e16DOI: (10.1016/j.fertnstert.2007.04.003) Copyright © 2008 American Society for Reproductive Medicine Terms and Conditions

Figure 3 (A) Congenital absence of ampullary part of fallopian tube. A blocked but normal looking fimbria is seen near ovary. The dotted line at the terminal end of the blocked tube indicates the area to be excised followed by longitudinal slitting of the opening to make it look “fish mouth” in appearance. (B) Two anchoring stitches are placed on either lip of the fish-mouth opening. An opening is made at the central region of the blind fimbria with a stab knife. The tips of a mosquito artery forceps are inserted through this newly created opening on the fimbria to grasp the anchoring stitches. (C) With traction on the anchoring stitches, the lips of the fish-mouth opening are pulled outside the fimbria. (D) The lips of the opened tube are everted and fixed to fimbria with 4/0 vicryl. Fertility and Sterility 2008 89, 723.e13-723.e16DOI: (10.1016/j.fertnstert.2007.04.003) Copyright © 2008 American Society for Reproductive Medicine Terms and Conditions