Embryo transfer can be performed in either uterine horn. Two successive pregnancies in a patient with uterus didelphys: a case report

Zakwan Khrait

doi:10.1186/s13256-021-02884-5

Abstract

BackgroundUterus didelphys results from a failure in Mullerian duct fusion and may be associated with complete or partial vaginal septa. Most cases of uterus didelphys are discovered incidentally during the workup of infertility or recurrent miscarriage. The incidence of uterus didelphys has been reported to be 0.2% in the infertile population.Case presentationA 35-year-old white Arab woman, gravida 0, parity 0, with a history of primary infertility of 8 years (a well-known male factor) presented to our infertility center. She was diagnosed as having uterus didelphys with severe male factor. The patient had three previous failed in vitro fertilization/intracytoplasmic sperm injection cycles outside our center.This is a case report of an infertile woman with uterus didelphys who conceived twice following single embryo transfer in both uterine horns successively. After the first successful pregnancy in the left uterine horn, the initial decision was to transfer the embryo to the same horn (left) because of the previous successful transfer. The very deep and long vagina forced us to reach one of the cervices, in which the embryo was placed in the right uterine horn, followed by the second successful pregnancy in the other, smaller horn. The patient gave her informed consent, both verbal and written, to use her information and images for medical publication.ConclusionPregnancy is possible in women with uterus didelphys using single embryo transfer in in vitro fertilization/intracytoplasmic sperm injection cycles. It is recommended that both horns be given a chance.

Highlights

The uterus forms during embryogenesis by fusion of the two paramesonephric ducts (Mullerian ducts)
Pregnancy is possible in women with uterus didelphys using single embryo transfer in in vitro fertilization/intracytoplasmic sperm injection cycles
It was made owing to the Conclusion Due to the extreme rarity of this condition, only few reports have described how to deal with this case with regard to embryo transfer in in vitro fertilization (IVF)

Summary

Introduction

The uterus forms during embryogenesis by fusion of the two paramesonephric ducts (Mullerian ducts). Case presentation A 35-year-old nulliparous Arab woman with an 8-year history of primary infertility presented to our infertility center During these 8 years, she was diagnosed with uterus didelphys with two cervices and no vaginal septum (Fig. 1). No magnetic resonance imaging (MRI) was done since the 3D US was enough to determine the sizes of both horns, which showed minor differences in dimensions She had no specific history, apart from her irregular period explained by the diagnosis of polycystic ovary syndrome (PCOS), was not a smoker, and did not consume alcohol. The first child was with them, showing very good progress, normal development, and intelligence as per her parents They extended their request to transfer one of the frozen embryos. An elective C-section was performed at 34 weeks for a baby boy of 2650 g weight, 47 cm length, 31 cm head circumference, and 6/10 Apgar score at delivery

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