CRITICALLY LOW AMH , ENDOMETERIOSIS AND CERVICAL STENOSIS

A young couple from middle east married in their mid 20’s .

planned to start their family after three years of being married , but failed to conceive due to infertility issues . tried naturally through medical management for 1 year but no luck . they had given up on hope of becoming parents and their conservative background made it difficult for them to choose IVF.
They were then referred to IVF-WORLD by a friend who had visited INDIA for their treatment .
on contacting us and after reviewing their case with our team of doctors we understood that theirs was a critical case and would need more assistance and treatment had to be tailored accordingly.
our team assisted them with their visas and made arrangements of their stay and travel as per their preferences so they could have a comfortable stay in INDIA.
once they arrived in india our assistance team made them reach out to their doctors who briefed them about how they would undergo their treatment.
diagnostic tests confirmed critically low AMH levels which almost suggested ovarian failure , increased thyroid levels and further scans revealed endometeriosis and cervical stenosis ( a tight cervix which prevents entry and makes it difficult to do the procedure). patient also had a history of painful periods .
our doctors firstly suggested hysteroscopy to treat cervical stenosis and meanwhile the patient was put on a special diet and a holistic programme to help recover and improve chances of conception . also an endocrinologist to keep the thyroid levels in control
on recovery , ovulation induction was started both orally and through gonadotrophins injectables to stimulate follicle growth . she was kept on a high dose of injectables to maximise ovarian stimulation and also progesterone injection ( hormone supporting pregnancy ) and estradiol for a healthy endometrium lining to support healthy implantation of the embryo in the uterus .
only five follicles were formed which could be taken out on the day of retrieval .
all five follicles were fertilised and frozen embryos were preserved .
this cycle was skipped to allow the ovaries to settle down completely due to overdose of FSH injectables , overdose was given due to a very low ovarian reserve .
embryo transfer was planned on day five , three embryos transferred to increase chances of conception .
one embryo was implanted in the uterus and there was another one in the cervix canal.
as the patient had already flown back to their home country a controlled D&C was performed by the doctors in their home country to remove the cervical ectopic pregnancy after complete consultation with our doctors which turned out to be successful at 6 weeks and the other embryo continued to grow in the uterus .
the couple is now on their way to a healthy pregnancy of 28 weeks and we are hopeful that she will be able to carry the baby to term .