Monday, April 25, 2016

Mullerian Dysgenesis - An Information

Dr. E.C.Sreevalsan, B.A., M.D., D.G.O.,[(Retd.) Addl. Prof. of Obs. & Gyn., Madras Medical College, Chennai.], after retirement, has been treating cases of Azoospermia and Mullerian Dysgenesis (for which Allopathy has no treatment), with Ayurvedic Compounds, since his primary medical qualification was GCIM.,  having obtained it, from the erstewhile Government College of Integrated Medicine, Kilpauk, Chennai.600010., opting, for the Ayurvedic System.

He was granted a Patent entitled “An unique combination of Ayurvedic Compounds for correcting a rare form of Mullerian Dysgenesis” by the Government of India in February, 2005. He started correction of Mullerian Dysgenesis on 1-4-2005, as and when cases came, at A.G.Chromepet Public Health & Maternity Centre, Chromepet, Chennai. 600044. (044-22355503) as a prospective one and on completion of 10 years, has written a review, which has been highlighted by the Tambaram Branch of Indian Medical Association in its website – www.imatambaram.com. Further details of the recorded changes are available on www.mullerian-malformations.blogspot.com. &  http://drecsreevalsan.blogspot.com.

In Mullerian Dysgenesis (faulty growth of uterus), we find fusion and non-fusion defects (midline uterus without cavity and in non-fused variety, we have unilateral and bilateral uterine nodules without cavity). Since they lack cavity, they are incapable of developing lining, and shedding, is, hence, impossible. They manifest in nature, as cases of primary amenorrhoea of anatomic origin and they go through life, without any hope of change, in their status.

 The incidence of this condition in India is not known. (The reported combined incidence of M.Agenesis, M. Dysgenesis and Regression after initial Eugenesis, is < 1 % in the advanced countries). The current incidence of mullerian anomalies in the general population is 5 %. (Yen & Jaffe’s Reproductive Endocrinology, 7th. edition.2014.). Our population has exceeded 1.3 billion and hence you will realise the significance of this medical option.

The overall changes, during the last ten years is given below
(1). On the uterus/uterine nodule. (Mullerian tissue).
  (a). Mensurational (growth) changes – there has been 3 D increase.
  (b). Formation of cervix and establishment of cervico-corporeal ratio.
  (c). Cavity creation. (Unreported, till date in medical literature).
  (d). Endometrial lining formation. (Same as above).
  (e). Attainment of menarche. (Same as above)
  (f). Cavitation from below upwards in vaginal agenesis to expose the cervix   
        and fornices. (MRI  -  for confirmation).
  (g). Fusion of the disparate mullerian nodules to form a uterus with cavity 
                    and lining which is growing. (serial USG Scans).
  (h). Vaginae have developed, in those who had none.

NB: All the above changes have been demonstrated by USG Scan and in one case MRI to confirm continuity of cavitation between uterus and vagina. Once cavity and lining develop, one more therapy (hormonal) becomes available.

 (2). On Hormones.
             Spontaneous correction of FSH hormone levels, have taken place and  
             TSH levels are nearing normalcy, within a short span of 8 months.
NB: Hormonal assessments are done at the beginning of correction and every three months thereafter.

(3). On the psychosexual aspect.
        In general, the individuals are hopeful and active (once they commence   
        correction). An unexpected change, especially among those who have  
        developed vagina, uterine  cavity and lining, is that they are thinking in 
        terms of parity with normal menstruating women. As a matter of fact 4 
        have entered into matrimony and are doing well.
NB: It is obvious that there is potential in this regime and a follow-up will definitely yield results.

An Ayurvedic Regime has, now proved, that their status can be changed and that they can join the ranks of normal women. Out of 19 cases of mullerian dysgenesis, who underwent treatment (the first case came on 3 – 8 – 2009 and the last one on 18 – 6 - 2015), (a) there was 1 hypoplastic uterus (left-sided with cavity but with agenesis of the upper vagina) and with a non-canalised uterine nodule on the other side, and with multiple anomalies. (American classification is available).
(b) There were 2 unilateral nodules without cavity and both showed the left kidney in the pelvis (one dropped out) and (c) There were 16 bilateral uterine nodules without cavity, of whom, 1 showed multiple anomalies (Patent ductus arteriosus – corrected in the neonatal period, bilateral fused radius and ulnae (with left sided normal movements of the digits but with absent pronation and supination of the elbow and the right hand showed flexion of the little and ring finger (claw hand) with fairly free movements of the other three digits, fused kidneys, in the pelvis, as well as bilateral uterine nodules. There has been progressive formation of cavity in nodules.

In October, 2015, two more have developed cavity (the case mentioned above was one, as well as the one who came for correction on 18-6-2015 (in the fifth month) and now, all the 18 cases have developed cavity. (in 17,-uterine cavity and in 1-upper vaginal cavity). (Luckily, the few women sufferers of our country, who have undergone correction and benefitted thereby, are better off than their counterparts in the rest of the world).

Of these 17 cases, 3 have attained menarche (arrangements are in place for collection of blood and confirmation of it as menstrual blood by getting the opinion of the pathologist) and 4 of them have entered into matrimony and are doing well.
There are no reports (in fact, no reported attempt) of development of cavity and lining in rudimentary uterus or uterine nodule in medical literature.
NB: A write up, has appeared on page 3. Mathrubhoomi Daily.-Chennai Edition. Dated -24/11/2015.


The following are available at AG.Chromepet Public Health & Maternity Centre, Chennai.44., -  (a) Board, (b) Patent Copy and (c) Report (in computer – hard copies for perusal).

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