Pregnancy in a case of adenomyosis and multiple fibroids!
Couple History of Infertility
- Mrs. ST and Mr.BD, 35 and 40 years old respectively, presented as a case of primary Infertility.
- There was a history of failed AID ( IUI with donor sperms)- 3 cycles outside.
- Mrs. ST had undergone laparoscopy myomectomy with endometriotic cyst excision.
- AMH :3.9
- Semen analysis: Azoospermia
- USG: Adenomyotic uterus, adherent, high ovaries, low antral follicular count
- Hysteroscopy: normal cavity.
- Azoospermia, adenomyosis, endometriosis
- Couple was advised self ICSI. Option of embryo donation was also discussed in view of adherent ovaries, endometriosis, low AFC on scan and anticipated difficult egg retrieval.
- Couple opted for embryo donation.
- During Embryo donation cycle, three day 3 embryos were transferred after laser assisted hatching. Beta Hcg done 15 days post transfer was positive. However after initial rise in value, beta HCG dropped resulting in biochemical pregnancy loss.
- Second embryo donation cycle was done later which resulted in failure.
Patient underwent laproscopic myomectomy with adenomyoma excision , esxcision of endometriotic spots and adhesinolysis later. After surgery hormonal injections were given for 2 cycles for disease suppression.
- Third cycle of Embryo donation was done later with transfer of three blastocysts.
- Beta Hcg done 15 days later was positive and doubled well. Scan done at 6weeks showed twin live pregnancy.