Woman with complicated Septate uterus surgery conceives: Thanks to medical intervention

Bengaluru, Sept. 21: Conceiving a baby is an utmost joy for a woman. However, a few women who suffer from septate uterus often lose the chance of motherhood.

“A 33-year old woman who had never conceived earlier came to OPD with desire to conceive. She had a septate uterus (A congenital anomaly where a membrane runs down the middle of the uterus splitting it into two parts). This is a birth defect seen in around two to three per cent of women. A diagnosis of this condition is reached when a woman is undergoing work up for infertility, frequent abortions or occasionally while doing a caesarean section, as an incidental finding”, she said.

Unfortunately, the woman patient had earlier undergone surgery for septate uterus two years ago without any success. After her previous surgery, her menstrual bleeding came down drastically. Now, she was diagnosed with Asherman Syndrome (a rare condition where scar tissue, also called adhesions or intrauterine adhesions, builds up inside your uterus. This extra tissue creates less space inside your uterus”, Dr Sneha said.

In a rare case, Dr. Sneha J (Infertility specialist and Cosmetic Gynaecologist, NU Hospitals, Rajajinagar) helped a woman conceive despite numerous medical challenges.

Thanks to the medical intervention, the menstrual blood flow improved to one to two days of decreased flow in the subsequent cycle. She was happy that she was bleeding again during her cycle, though not like before. Her embryo transfer was planned in a natural cycle after five months, giving adequate time for the uterus to heal to harbour a healthy pregnancy. Uterine lining was not adequate and embryo transfer had to be cancelled for two consecutive months.

“We used the latest technique of injection of Platelet rich plasma (PRP) into the uterine cavity to improve the uterine lining to house the embryo and allow its successful growth. PRP acts by increasing growth factors in the uterus. The Uterine lining grew to 5mm which is still below the standard proposed- 7mm. After explaining the chances of embryo implantation, we transferred two embryos into the uterus. A good thick uterine lining is required for success in an IVF /ICSI cycle as this provides space and nutrition to the developing embryo”, Dr Sneha said adding that the biggest surprise was when her pregnancy test turned positive. Her scan at six weeks showed that both the embryos were implanted in the uterus and one had a heart beat too. The other fetus stopped growing which was confirmed during the eighth week scan. Now she is 10 weeks pregnant with a normal growing fetus inside.

“Septal resection is a commonly performed procedure with good results. About 60 pc of women conceive naturally after septal resection if this was the cause of infertility. Complications can happen with any procedure in medicine and we must find ways to tackle it”, she added.

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