<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:An otherwise healthy 16-year-old girl comes to the physician because she has not had a menstrual period. Examination shows normal breast development. There is coarse pubic and axillary hair. Pelvic examination shows a blind vaginal pouch. Ultrasonography shows normal ovaries and an atretic uterus. Which of the following is the most likely underlying cause of this patients symptoms?? A: Deficiency of 5-alpha reductase, B: End-organ insensitivity to androgens, C: Monosomy of sex chromosomes, D: Agenesis of the paramesonephric duct, E: Deficiency of 17-alpha-hydroxylase,  <response>: This is a clinical case of a 16-year-old girl with primary amenorrhea. The key findings are normal breast development, presence of pubic and axillary hair, blind vaginal pouch, normal ovaries but atretic uterus on imaging. This indicates normal secondary sexual development has occurred, suggesting appropriate estrogen levels. However, the uterine agenesis points to a Mullerian duct abnormality during embryonic development as the likely cause.Choice A can be eliminated, as 5-alpha reductase deficiency would cause undervirilization in a female due to impaired conversion of testosterone to DHT. Choice B can be eliminated, as end-organ insensitivity to androgens would not explain the uterine agenesis. Choice C can be eliminated, as sex chromosome abnormalities like Turner syndrome lead to ovarian dysgenesis, not an isolated uterine anomaly.Choice E can be eliminated, as 17-alpha-hydroxylase deficiency would impair sex steroid synthesis and cause lack of secondary sexual development.Choice D, agenesis of the paramesonephric Mullerian ducts, is the most likely diagnosis given the clinical findings. This would lead to normal ovarian function but uterine agenesis.D: Agenesis of the paramesonephric duct 