Overcoming Challenges to Achieve Parenthood

This case involves a 39-year-old woman and her 41-year-old husband, who have been married for 20 years. Five years ago, they experienced a natural pregnancy, but it ended in an ectopic pregnancy, which required surgery. The woman had a long history of severe PCOD/PCOS (polycystic ovary disease), which caused very irregular periods. Without medication, she couldn’t get her period at all. She also had excessive facial hair and struggled with obesity.

In early January 2024, the couple visited our clinic after having difficulty conceiving again. They were ready to explore treatment options to start their family.

The first approach was intrauterine insemination (IUI), but it didn’t work as expected. The woman’s PCOD/PCOS caused issues with follicle development, and she couldn’t release an egg. This led us to consider IVF, which would give us more control over the process.

In the first IVF cycle, things seemed to go well. The patient conceived, but sadly, the pregnancy ended in a miscarriage at around six weeks. This setback was hard for the couple, but we kept working to identify any other factors that might affect the pregnancy.

To understand the cause of the miscarriage, we performed a hysteroscopy, which showed a large fundal septum in the uterus. This is a condition where there is an indentation (like a curtain) in the uterus which can make implantation difficult. We performed a surgery called septoplasty to remove the septum. After that, we found that the lining of the uterus was healthy and ready for the next step.

While preparing for another embryo transfer, an endometrial polyp was found in the uterus. Polyps can reduce the chances of pregnancy after IVF, so we decided to remove it with another hysteroscopy. After the polyp was removed, we were ready for the next transfer.

In 2024, the patient underwent another embryo transfer. This time, the embryo implanted successfully, and the pregnancy progressed well. But at around six months, the woman was admitted to the hospital for preterm labor. She also developed high blood pressure and diabetes, both of which were linked to her PCOD/PCOS.

Despite these complications, the pregnancy continued under close monitoring. The team carefully managed her diabetes and blood pressure to keep things on track. In the ninth month, the patient had an elective C-section. She delivered a healthy 2 kg baby, and both mother and baby were in good health. The baby didn’t need any time in the NICU and was able to go home with the mother shortly after birth.

This case highlights the challenges the couple faced but also how they overcame them with the right medical interventions. From IVF to surgeries for uterine abnormalities and managing complications during pregnancy, everything came together to help the couple achieve their dream of becoming parents.

Despite the obstacles, both the mother and baby were healthy, and the couple could finally start their family. This case shows how careful planning, monitoring, and treating underlying conditions can make a big difference in achieving a successful pregnancy.