Experts from Pune’s Indira IVF clinic treated a couple with advanced assisted reproductive techniques
Pune: A 38-year-old woman was treated for a case of heterotrophic pregnancy at an Indira IVF clinic in Pune. Heterotrophic (HT) pregnancy is a phenomenon in which two embryos are formed but one exists inside the uterus and the other is implanted ectopically, that is, anywhere but not in the inner lining of the uterus. Anita (name changed) and her husband had undergone three rounds of IVF (in vitro fertilization) but were met with unsuccessful outcomes, including a missed abortion at 6-7 weeks before they turned to the city clinic for help.
Upon undergoing a number of tests, Anita was found to have very low levels of Anti-Müllerian Hormone (AMH 0.76) and had a diminished ovarian reserve, indicating that the number of viable eggs in her ovaries were negligible. Her husband was diagnosed with azoospermia which is the absence of sperms in the semen. Due to this, they were recommended IVF with donor embryos wherein donor eggs and sperms are used for the procedure instead of the couples.
Elaborating on the procedure, Dr. Kshitiz Murdia, CEO of Indira IVF said, “Infertility does not affect only women, but also men. In a third of couples, there might be underlying health conditions in women leading to infertility, and in another third, it might be because of diseases in men. The remaining third can be traced back to both, like in the case of Anita and her husband. In such cases, using donor embryos is a feasible solution.”
Dr. Amol Lunkad and Dr. Satish Londhe worked as a team to treat Anita’s condition. Two embryos were transferred into Anita’s uterus in September 2020 and subsequently, a beta-HCG (human chorionic gonadotrophin) test declared her as clinically pregnant. While performing an ultrasound, one embryo was observed to be implanted in the uterus, however, the other embryo was implanted in the isthmic region of the left fallopian tube. Such ectopic pregnancies lead to complications and usually cause abortion.
Anita’s left fallopian tube was surgically removed (salpingectomy), thus, also removing the embryo implanted in the region. A post-operative image scan showed that a single pregnancy remained in an appropriate region of the uterus.
“About 20-25% of cases of HT pregnancy can be asymptomatic, 70-75% of cases can cause pain, and about 50% can lead to vaginal bleeding. We try to take the route that causes the least harm and presents the best outcome option for the couple. It is essential that all pregnancies and sonographies are monitored closely so that ectopic cases can be diagnosed and treated at the earliest,” added Dr. Murdia added.
HT is a rare complication that is observed in 1 per 30,000 cases of natural pregnancies. About 1-2% of IVF pregnancies may also lead to HT, and the rate for the same can be determined by the number of embryos transferred. Patients who experience this complication tend to have a history of infertility – like in the case of Anita and her husband – or tubal diseases. The most common site for an ectopic pregnancy is the fallopian tube, followed by the cornu.
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