Despite numerous Eastern and Western medical treatments, two intrauterine insemination (IUI) procedures, and three in vitro fertilization (IVF) cycles, Ms. Phuong experienced repeated failures. Professor Doctor Le Hoang, Director of the Reproductive Support Center at Tam Anh General Hospital Hanoi (IVF Tam Anh), ordered a hysteroscopy combined with laparoscopy to diagnose the underlying cause.
Professor Hoang explained that hysteroscopy provides direct visualization of the entire uterine cavity, enabling detection of abnormalities that might be missed by transvaginal ultrasound, saline infusion sonography, or hysterosalpingography. This method proves particularly beneficial for women with repeated failed embryo transfers, recurrent miscarriages, or prolonged unexplained infertility. Furthermore, the technique allows for immediate treatment of any lesions discovered during the procedure. When paired with histopathological examination, it stands as the "gold standard" for diagnosing uterine cavity pathologies, boasting high sensitivity and specificity.
In Ms. Phuong's examination, Professor Hoang identified numerous large polyps, measuring 2,2 cm, alongside dozens of smaller ones, all densely clustered within the uterine wall. This condition represents an excessive proliferation of endometrial glands and stroma, which obstructs sperm movement and impairs embryo attachment and implantation. Even if conception occurs, large polyps can elevate the risk of early miscarriage.
Following polyp removal and confirmation of clear fallopian tubes, doctors determined Ms. Phuong could conceive naturally. If she underwent IUI, her pregnancy chances would increase by approximately 30%; with IVF, the success rate could reach 50-65%. After one year, the couple's attempts at natural conception were unsuccessful, prompting their return to IVF Tam Anh for in vitro fertilization.
While the wife's ovarian reserve was good, the husband's sperm exhibited weakness, with high rates of immotility and abnormalities. Doctors devised a tailored treatment protocol, aiming to cultivate multiple good quality embryos and ensure the uterine lining was optimally prepared for successful embryo attachment and implantation.
Ms. Phuong underwent ovarian stimulation and egg retrieval. Her husband's sperm sample was washed and processed to select the healthiest sperm. Embryologists then performed intracytoplasmic sperm injection (ICSI). Embryos were cultured in an AI-integrated time-lapse incubator system, monitored continuously 24/7, yielding four day-5 embryos and three day-6 embryos of good quality for cryopreservation. Ms. Phuong conceived on her first embryo transfer and welcomed her first son, weighing 3,5 kg, in late 2025.
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Professor Le Hoang performs egg retrieval for a patient. *Illustration: IVF Tam Anh* |
Professor Hoang stated that at IVF Tam Anh, uterine polyps cause approximately 10-15% of female infertility cases. The condition often presents without symptoms, leading many cases to be discovered only during routine gynecological check-ups. The most common symptom is abnormal vaginal bleeding. While the exact causes remain unclear, some instances are associated with elevated levels of the female hormone estrogen, chromosomal abnormalities, and chronic endometrial inflammation.
Doctors advise women who have been trying to conceive for one year without success (or six months if over 35 years old) to seek a reproductive health check-up. Early detection of uterine abnormalities significantly improves treatment success rates, reduces costs, and prevents unnecessary interventions. For those who have undergone polyp removal, planning pregnancy promptly is recommended to mitigate the risk of recurrence affecting fertility.
Trinh Mai
