Title: Case Report: Female circumcision and infertility

Biography:

Abdelmonem Hegazy is a Professor and Former Chairman of Anatomy and Embryology Department, Faculty of Medicine, Zagazig University, Egypt; Consultant of Obstetrics, Gynecology and Infertility; Global Goodwill Ambassador (GGA); Referee Member of Scientific Research for Professors' Promotion in Egyptian Universities; Participation in Evaluation of Professors' Promotion at John Hopkins University, USA; Editor-in-Chief "International Journal of Human Anatomy (USA)"; Editor-in-Chief "Women’s Health and Complications" (UK); Editor-in-Chief "Zagazig University Medical Journal (ZUMJ)" (ARE); Editor Board Member in more than 100 international journals; Reviewers in many other international journals; & Member of IRB "Institutional Research Board", Faculty of Medicine, Zagazig University, Egypt.

Abstract

Female circumcision also called genital cutting or mutilation is an ancient Egyptian practice. It is an invasive procedure of non-medical purposes (1). Nowadays, it has been documented in many other countries all over the world. It threatens about three millions girls every year (2). We report a case of a married couple coming to the clinic with a complaint of infertility. On physical examination of the vulva, there was adhesion of labia minora forming a fibrous septum against proper sexual vaginal intercourse. Past history indicated female circumcision done before marriage. Other parameters of investigations were within the normal values. Cutting of the septum and suturing the raw surfaces of the edge on either side were done under anaesthesia and sterilization precautions. Pregnancy occurred within three months of the procedure. Our case was of the most common performed type of circumcision with excision of the clitoris and the two labia minora that represent the most sensitive organs (3). At circumcision, these organs are hold by forceps; and rose away from the body; then they are cut together (1). Since the operator is non-medical, he/she does not perform suturing the raw edges; and instead keep the victim with approximated thighs to prevent bleeding. Long staying in such approximation results in adhesions between the raw edges on both sides and then formation of the fibrous barrier in-front of the urethral and vaginal openings of the vestibule. It is concluded that female circumcision could result in infertility through adhesions of edges of the wound.