In contrast to clearly identified genetic mutations, such as those affecting the HOX or WNT genes, epigenetic changes, such as overexposure to estrogens or abnormal expression of HOXA genes, as well as activation of the antimullerian hormone (AMH) promoter, suggest a more complex and less predictable mechanism that could contribute to the development of MRKH syndrome (Thomson et al., 2023). Here, AMH is linked to Mayer-Rokitansky-Küster-Hauser syndrome.