An additional concern is the teratogenic effects of isotretinoin in patients with natal female internal genitalia. While these patients may not think they can get pregnant because of testosterone-associated amenorrhea, the potential is still present and pregnancy should be avoided, Dr.
In fact, asymmetry of the eversible vesica is nearly universal in Lepidoptera (Chapman 1902) and appears associated with asymmetry in the female internal genitalia (Huber et al.