Successful pregnancy in woman with Bilateral tubal blockade

Mrs W, 22yrs old nulliparous woman,a homemaker,reported to prana fertility center ,with inability to achieve pregnancy for 3 years of marriage.Her menstrual cycles was normal in duration and flow,and ovulatory as per history.Her general examination was normal and physical examination of abdomen revealed no abnormality.Pelvic examination was also normal.She had done saline salphinography [SSG] at previous hospital which showed bilateral tubal obstruction.

     Following her initial consultation,hormonal profile was done on day 2 of her menstrual cycle which were found to be in normal limits.Serum AMH :2.2ng/ml.Transvaginal ultrasound [TVS] showed antral follicle count (AFC) on both ovaries were 10 & 12.Right ovarian volume of 9.5cc & left ovarian volume of 7.6cc noted.Uterine dimensions of 6.9*5.1*3.4cm and uterine contour was normal. Endometrium thickness measured about 3.1mm.POD free.

She was advised Hysterosalphinography on day 7 of menstrual cycle which revealed bilateral corneal tubal block and uterine cavity was normal.

Husband’s semen analysis was within normal limits.

  Diagnosis of tubal factor primary infertility was made . She was counselled for laparoscopy “a gold standard procedure” in diagnosing tubal pathology,thereby therapeutic intervention  if any tubal pathology identified with risks & success rates of procedure  was fully discussed to couple.

Couple refused any form of open and minimal access surgery.

Couple opted for IVF [In Vitro Fertilization].Following ovarian stimulation with exogenous hormone injection,oocyte retrievel was done.Intracytoplasmic Sperm Injection [ICSI] is a superior & micromanipulation technique used in IVF lab.ICSI involves injecting a healthy sperm into the cytoplasm of an egg using a fine glass needle in laboratory and embryos formed are cryopreserved.Subsequent personalized embryo transfer was done for this couple.

  For this couple, we retrieved 14 oocytes of which 9 oocytes were fully mature & ICSI was done for the same. After 18 hrs ,8 oocytes were fertilized.Finally we obtained 4 [day 3]embryos & 1 [day 5] embryo of top quality.

In subsequent cycle,2 [day 3] embryos are transferred into uterine cavity when endometrium was ready. On 14^th day of post embryo transfer, urine  pregnancy test was positive & beta hcg value of 588mIu/ml was noted . Beta hcg doubling was good. Dating scan showed single intrauterine gestation of 5 weeks.

Couple were delighted & thanked our prana fertility team for having detected the cause of infertility,dealing with it it so effectively & helping them conceive in first cycle.