“…However, virilization is never observed in MRKH syndrome, and therefore, the loss-of-function mutations of Wnt4 are not likely to be the cause of the syndrome in its original presentation [16]. Moreover, sequencing of the WNT4 gene in 19 MRKH patients reinforced the notion that Wnt4 mutations leads to an MRKH-like syndrome associated with hyperandrogenism, which might be a distinct clinical and genetic entity from MRKH syndrome [65,67,68]. Additional studies involving mutational analysis of the WNT4 gene in women with MRKH syndrome have reached similar conclusions and exclude WNT4 as a major gene responsible for MRKH without virilization [36,59,67,69].…”