Primary amenorrhoea is seen in all except: (Repeat)

Ans: C (Ashermann syndrome) Ref: Dutta's Gynecology pg 433Explanation:(See Table 17 and Figure Below)Asherman's syndrome or Fritsch syndromeIt is characterized by adhesions and fibrosis of the endometrium.Most often associated with dilation and curettage of the intrauterine cavity.Patients present with secondary amenorrhea. Table 17 : Causes of Primary AmenorrheaOutflow tractAnomalies/obstructionGonadal/end-organ disordersPituitary and hypothalamicUterine* Mullerian agenesis (2nd MC cause)* Gonadal dysgenesis, including Turner syndrome, is the most common cause* Androgen insensitivity syndrome {Testicular feminization syndrome)* Receptor abnormalities for hormones FSH and LH* Specific forms of congenital adrenal hyperplasiaHypothalamic: Kallmann syndromeVaginal:* Vaginal atresia,* Cryptomenontioea* Imperforate hymen.* Swyer syndrome* Galactosaemia* Aromatase deficiency* Prader-Willi syndrome* Male pseudo-hermaphroditism Approach to Primary Amenorrhea History and Physical Exam | Uterus Present Uterus absent or uncertain || |FSH -20 IU/L and' LH >40 IU/LFSH -20 IU/L and' LH >40 IU/L || KaryotypePatient Hypogonadotropic HypogonadismEating disordersBrain injury or irradiationKallman SyndromePituitary defectHyperprolactinemiaHemochromatosisHypergonadotropicHypogonadism | |KaryotypePatient 46. XX46. XY||||45. XO46. XXMullenanAgenesis/MayerRokitansktKusterHauserSyndromeAndrogenInsensitivitySyndrome.Vanishing TestesSyndrome.5 alpha reductase deficiency|| TurnerSyndromePremature OvarianFailureConsider MRI