In a study by Brucker et al., endometrial stroma cells derived from patients with MRKH syndrome exhibited significantly less decidualization compared with healthy controls in addition to lower hormone responsiveness, possibly indicating a dysfunctional hormone receptor function that may play a role in the etiology of MRKH syndrome [13]. This evidence concerns the gene NR4A1 and Mayer-Rokitansky-Kuster-Hauser syndrome.