Abstract Primary infertility in adult couples is most commonly attributed to ovulatory dysfunction, tubal pathology, or male factor abnormalities. Rarely, congenital Anorectal Malformations (ARMs) persisting into adulthood may create atypical urogenital contamination pathways, predisposing both partners to recurrent genital infections. We report an unusual case of a married couple presenting with recurrent Pelvic Inflammatory Disease (PID) in the female partner and chronic, treatment‑resistant balanoposthitis in the male partner. After extensive evaluation, the underlying cause was identified as a previously unrecognised variant low anorectal malformation in the woman, resulting in a concealed recto‑vestibular fistulous tract. Surgical correction led to complete resolution of infections in both partners and subsequent spontaneous conception. This case highlights the importance of considering congenital anorectal variants in adults with unexplained recurrent genital infections and infertility.
DR et al. (Thu,) studied this question.