This document summarizes congenital anomalies of the male and female genitalia that can occur during early fetal development. It describes how the genitalia initially develop similarly in both sexes, but differentiate by 12 weeks. Common anomalies include abnormalities of the gonads, genital ducts, and external genitalia. Specific issues covered include agenesis or dysgenesis of the ovaries/testes, hermaphroditism, undescended testes, and anomalies of the penis, clitoris, uterus and vagina such as duplication, absence or fusion defects. The document was presented by Dr. Marwan Alhalabi at a conference in Erbil, Iraq in 2013.

1. Iraq - Erbil 2013
Marwan Alhalabi
Professor of Reproductive Medicine and Infertility,
Damascus University
Head of Assisted Reproduction Unit, Orient Hospital
President of Middle East Fertility Society
President of Syrian Society of Obstetricians and
Gynecologists

2. 1. Gonads Ovaries or testes
2. Genital Duct Systems
Mesonephric and Paramesonephric ducts
3. External Genitalia

5. • Early, similar in both sexes
• 6th wk, three external protuberance surround cloacal membrane, the
left and right genital swellings meet anteriorly to form the genital
tubercle.
• 12th wk identify difference.
• Genital swelling labioscrotal folds scrotum or labia major
• Genital tubercle phallus penis or clitoris

6. • Absent, bifid or double
clitoris
• Enlarged clitoris in case of
hermaphroditism and
congenital adrenal
hyperplasia
• Labia minora may show
partial fusion
• Urethra open on the
anterior wall of the vagina

7. • agenesis or complete absence.
• Gonadal dysgenesis "streak gonads" as in Turner
syndrome.
• Failure of descent into the pelvis.
• Ovotestis “true hermaphrodite” In which
combined ovarian and testicular tissues seen.

8. Ovary in inguinal
canal
Teratoma

9. • Absent, on one or both sides.
• Partially, or completely, duplicated on one or both sides.
• Atresia of the tubes.

11. 1) Agenesis of Penis.
2) Micro Penis.
3) Bifid Penis (Double).
4) Retroscrotal Penis.
5) Hypospadias.
6) Epispadias.

22. Congenital Anomalies
of
Uterus and Vagina

23. Absence of Uterus Fusion anomalies

24. 1. Agenesis of uterus/vagina: Rokitansky-Kuster-Hauser
Syndrome.
2. Unilateral development :Unicornate uterus
3. Defects in Vertical Fusion (obstructive or non-
obstructive)
4. Lateral Fusion defects (obstructive or non-obstructive).

28. Lateral Fusion Defects: obstructive and non-
obstructive

34. • Duplicated vagina; associated with
duplicated uterus
• Lumen subdivided longitudinally, or
transversely by a septum
• Absent of vagina
• Imperforate hymen
• Rectovaginal fistula
• Vesicovaginal fistula

40. Testicular Descent
Anomalies

41. 1) Cryptorchidism.
2) Ectopic testis.
3) Congenital inguinal hernia.
4) Hydrocele.

45. THANK
YOU

47. Clinical Team
S. Samawi
N. Kafri
S. Modi
M. Mousa
IVF Lab
o M.H.Droubi
o R. Doghoz
o A. Konali
Fetal Med.
A. Taha
M. Khalaf
M. Hazemah
Andrology Lab
W. Hamad
N. Assaf
M. Othman
N. Mazzawi
S. Sheko
Bio-Ginitic Lab
J.Sharif
A. Khatib
M. Kinj
Administration
F. Hamad
R. Qamar
M. Haj hasan
N. Olabi
E. Fayad
W. Saker
Med Engineering
Y. Khabori
S. Khayat
Anesthesia
R. Tarko
Y. Lakkis
M. Khadra
H. Sulaiman
Acknowledgement

48. 48