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Gonadal structures in a fetus with complete androgen insensitivity syndrome and persistent Müllerian derivatives: comparison with normal fetal development Sabrina Corbetta, M.D., Ph.D., Marina Muzza, Ph.D., Laura Avagliano, M.D., Ph.D., Gaetano Bulfamante, M.D., Luigi Gaetti, M.D., Cristina Eller-Vainicher, M.D., Paolo Beck-Peccoz, M.D., Anna Spada, M.D., Ph.D. Fertility and Sterility Volume 95, Issue 3, Pages 1119.e e14 (March 2011) DOI: /j.fertnstert Copyright © 2011 American Society for Reproductive Medicine Terms and Conditions
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Figure 1 Particulars of body examination during fetal autopsies. (A) Typically female external genitalia (E) with abdominal gonad (G) and increased volume. (B, C) Histologic examination of the paratesticular area revealing degenerative involution of Wolffian and Müllerian ducts. (D) Gonad examination showing normal fetal testis with normal tubular structures (T). The number and size of Leydig cells (L) were increased in (E) CAIS compared with (F) the normal control male. (Magnification: ×40; stain: hematoxylin and eosin). Fertility and Sterility , 1119.e e14DOI: ( /j.fertnstert ) Copyright © 2011 American Society for Reproductive Medicine Terms and Conditions
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Figure 2 Internal genitalia reconstruction of fetus with complete androgen insensitivity syndrome (CAIS). Vaginal epithelium: (A) index case and (B) normal female control. Insets show the histologic finding of vaginal epithelium (magnification: ×20; stain: hematoxylin and eosin). Uterine epithelium: (C) CAIS and (D) female control. (Magnification: ×60; stain: H&E.) Specific immunostaining in the uterine sections: In CAIS case, (E) antimüllerian hormone receptor type 2 (AMHR2) and (G) bone morphogenetic protein receptor, type IA (BMPR1A). In normal female fetus, (F) AMHR2 and (H) BMPR1A. Ut, uterus; Va, vagina. Fertility and Sterility , 1119.e e14DOI: ( /j.fertnstert ) Copyright © 2011 American Society for Reproductive Medicine Terms and Conditions
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Figure 3 Immunohistochemical analysis for antimüllerian hormone (AMH), antimüllerian hormone receptor type 2 (AMHR2), and bone morphogenetic protein receptor, type IA (BMPR1A) in testis sections from fetus with complete androgen insensitivity syndrome (CAIS) (left) and normal male fetus (right). (A, B) AMH showed a strong reaction in CAIS and in normal Sertoli cells (magnification: ×10). (C, D) AMHR2 had a peritubular distribution (magnification: ×20), but AMHR2-positive mesenchymal cells (arrows) were less represented in (C) CAIS than in (D) normal testis. (E, F) BMPR1A was expressed in Leydig cells of the (E) CAIS testis as well as of the (F) normal male control. Fertility and Sterility , 1119.e e14DOI: ( /j.fertnstert ) Copyright © 2011 American Society for Reproductive Medicine Terms and Conditions
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