{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T22:47:41Z","timestamp":1782082061799,"version":"3.54.5"},"reference-count":52,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100004801","name":"Shota Rustaveli National Science Foundation","doi-asserted-by":"publisher","award":["PHDF-24-1369"],"award-info":[{"award-number":["PHDF-24-1369"]}],"id":[{"id":"10.13039\/501100004801","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe individuals with differences in sex development presenting with a female phenotype and an absent uterus and identify specific diagnostic characteristics that improve diagnostic accuracy and optimize patient care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This descriptive comparative study included retrospective and prospective clinical data collected between 2023 and 2025 at the Reproductive Medicine Center \u201cUniverse,\u201d Tbilisi, Georgia. Among 233 individuals evaluated for primary amenorrhea, 26% with a female phenotype and an absent uterus who were evaluated for Complete Androgen Insensitivity Syndrome, Mayer\u2013Rokitansky\u2013K\u00fcster\u2013Hauser syndrome, and ovotesticular disorder of sex development were included in the final sample. All participants underwent clinical, hormonal, genetic, and imaging assessment. Laparoscopy and histomorphological examination were performed when indicated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Mayer\u2013Rokitansky\u2013K\u00fcster\u2013Hauser syndrome accounted for 57.4%, Complete Androgen Insensitivity Syndrome for 37.7%, and ovotesticular disorder of sex development for 4.9% of the cases. Complete Androgen Insensitivity Syndrome patients exhibited preserved breast development with absent or sparse pubic hair, whereas Mayer\u2013Rokitansky\u2013K\u00fcster\u2013Hauser syndrome and ovotesticular disorder of sex development patients exhibited normal pubic hair and breast development. Vaginal length was shortest in patients with Mayer\u2013Rokitansky\u2013K\u00fcster\u2013Hauser, intermediate in those with complete androgen insensitivity syndrome, and variable in patients with ovotesticular disorder of sex development. Complete Androgen Insensitivity syndrome patients demonstrated male-range testosterone levels; Mayer\u2013Rokitansky\u2013K\u00fcster\u2013Hauser patients exhibited female-range hormone profiles, and ovotesticular disorder of sex development patients were observed to have nonspecific endocrine patterns. Ovotesticular disorder of sex development was confirmed histomorphologically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>An integrated diagnostic approach combining specific clinical features, hormonal profiles, imaging, karyotyping, and histomorphology enables accurate differentiation of Mayer\u2013Rokitansky\u2013K\u00fcster\u2013Hauser, complete androgen insensitivity syndrome, and ovotesticular disorder of sex development.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03000605261457289","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T06:13:46Z","timestamp":1781849626000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Differences in sex development among individuals with a female phenotype and an absent uterus: Diagnostic approach"],"prefix":"10.1177","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3434-2530","authenticated-orcid":false,"given":"Ana","family":"Jibladze","sequence":"first","affiliation":[{"name":"Ivane Javakhishvili Tbilisi State University, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8779-7731","authenticated-orcid":false,"given":"Elene","family":"Asanidze","sequence":"additional","affiliation":[{"name":"Petre Shotadze Tbilisi Medical Academy, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alla","family":"Vash-Margita","sequence":"additional","affiliation":[{"name":"Division of Pediatric and Adolescent Gynecology; Department of Obstetrics, Gynecology, and Reproductive Sciences; Yale University School of Medicine; United States of America"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9216-1407","authenticated-orcid":false,"given":"Jenaro","family":"Kristesashvili","sequence":"additional","affiliation":[{"name":"Ivane Javakhishvili Tbilisi State University, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1159\/000499274"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(18)30339-5"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/cen.14528"},{"key":"e_1_3_7_5_2","unstructured":"Gasner A Rehman A. 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