Ms. Phuong conceived naturally and gave birth to a son in 2013. Subsequently, she experienced two unsuccessful pregnancies: one miscarriage and one ectopic pregnancy that required surgery to remove her left fallopian tube. She had undergone two surgeries to remove submucosal uterine fibroids, and for 4 years, she had not conceived again. The couple underwent in vitro fertilization (IVF) treatment at a hospital, but the embryo transfer was unsuccessful.

Doctor of First Degree Specialization Chau Hoang Phuong Thao, Head of the Reproductive Support Unit, Reproductive Support Center, Tam Anh General Hospital - District 8, diagnosed Ms. Phuong with secondary infertility. This condition, defined as infertility after a previous pregnancy, was attributed to submucosal uterine fibroids. These fibroids had either deformed or reduced the uterine cavity area, making it difficult for embryos to implant and develop.

Doctor Thao noted Ms. Phuong's good ovarian reserve, indicating a strong possibility of conceiving through in vitro fertilization (IVF). The patient received mild ovarian stimulation medication to encourage egg development to maturity while minimizing the risk of ovarian hyperstimulation syndrome. Doctor Thao then performed an egg retrieval, successfully obtaining 28 mature eggs.

Doctor of First Degree Specialization Chau Hoang Phuong Thao and her team performing egg retrieval for Ms. Phuong. *Photo: Tam Anh General Hospital*

Embryologists selected the husband's qualified sperm for injection into the egg cytoplasm. The resulting embryos were cultured in a time-lapse system, which optimized all conditions, yielding 5 day-5 embryos and 3 day-6 embryos. A camera system continuously monitored the embryos' development, and artificial intelligence software scored 4 embryos as good quality. These high-quality embryos were then cryopreserved, awaiting the ideal time for transfer.

Before the embryo transfer, Doctor Thao conducted a hysterosalpingography and a saline infusion sonography. These procedures aimed to examine the remaining fallopian tube and assess the endometrium. The results revealed a recurrence of submucosal uterine fibroids, measuring 10-15 mm. Consequently, Ms. Phuong was referred to the Obstetrics and Gynecology Center for hysteroscopic myomectomy to remove these fibroids.

After Ms. Phuong's endometrium was prepared to optimal conditions, Doctor Thao transferred one good day-5 embryo, leading to a successful pregnancy. The pregnancy is currently 12 weeks and developing healthily. The remaining embryos were cryopreserved, offering the couple the possibility of having more children in the future.

According to Doctor Thao, uterine fibroids are a common gynecological condition, affecting about 20-40% of women. While often asymptomatic, some cases present with symptoms such as prolonged or heavy menstrual bleeding (menorrhagia), bleeding lasting more than 7 days, and accompanying blood clots. This condition can reduce fertility, cause anemia, and lead to compression, potentially resulting in miscarriage or preterm birth. Women who undergo myomectomy still face a recurrence risk of about 15-30%.

Doctor Thao advises newly married women or those who have previously given birth, if they do not conceive naturally after 6-12 months, to seek early examination and treatment. Similarly, single women experiencing signs of menstrual disorders, such as prolonged or heavy bleeding, unusually long or short menstrual cycles, or severe pain during menstruation, should undergo a gynecological examination to detect and treat any abnormalities promptly.

Hoai Thuong

*Patient's name has been changed