Ms. Hiep and her husband have two children, aged 13 and 8. After one miscarriage, she had not conceived again for two years. Specialist Doctor Level II Cao Tuan Anh, from the Center for Reproductive Support at Tam Anh General Hospital Hanoi, diagnosed Ms. Hiep with multiple uterine conditions: endometritis, polyps, and fibroids. These conditions caused structural changes in her uterus, uterine motility disorders, fallopian tube obstruction, and uterine scarring, all of which affected the process of conception and embryo implantation.

Doctor Tuan Anh explained that chronic endometritis is a common cause of recurrent miscarriages, repeated failed embryo implantation, or unexplained infertility. The condition arises from bacterial invasion of the uterine cavity, often following procedures such as abortion, intrauterine device (IUD) insertion, hysteroscopy, or pelvic inflammatory disease.

Ms. Hiep was diagnosed with severe chronic endometritis. Doctors prescribed antibiotic treatment for two weeks. After controlling the inflammation, Ms. Hiep underwent ovarian stimulation, egg retrieval, and fertilization with her husband's sperm. The results yielded two mosaic embryos (a mix of normal and abnormal cells) and one genetically abnormal embryo.

Doctors performed egg retrieval for the patient. Photo: Tam Anh General Hospital

According to Doctor Tuan Anh, mosaic embryos carry a risk of miscarriage and fetal abnormalities. However, the patient had no normal embryos to transfer, while also suffering from numerous uterine conditions. Repeated ovarian stimulation and embryo transfers could lead to adverse outcomes for both treatment effectiveness and patient health, such as reduced implantation rates, hormonal disorders, increased risk of repeated failure and early miscarriage, and even worsening existing uterine pathologies. Therefore, doctors decided to transfer one mosaic embryo with a 40% mosaicism level (a low level according to the latest recommendations from the Preimplantation Genetic Diagnosis International Society (PGDIS)), but this attempt failed.

Ms. Hiep paused her fertility treatment to recover her health, returning to the hospital almost two years later to resume treatment. An outpatient hysteroscopy revealed numerous polyps growing in clusters, filling the uterus, and multiple fibroids.

She underwent laparoscopic surgery to remove the polyps and uterine fibroids. This procedure aimed to eliminate lesions that deformed the uterine cavity, restore the structure and function of the endometrium, and improve blood supply and the uterine environment for embryo implantation. Two months later, Ms. Hiep underwent mild ovarian stimulation and egg retrieval to create new embryos. Preimplantation genetic testing identified two normal embryos, three mosaic embryos, and one abnormal embryo.

Once her uterine condition stabilized, doctors transferred one high-quality day 5 embryo, which led to a successful pregnancy. In early January 2026, a healthy baby boy was born, weighing 3,2 kg.

According to Doctor Tuan Anh, uterine pathologies are a leading cause of difficulty conceiving in women. Conditions such as polycystic ovary syndrome, diminished ovarian reserve, fallopian tube obstruction, ovarian cysts, endometriosis, as well as lesions like infections, intrauterine adhesions, or endometrial polyps, can all hinder ovulation, fertilization, and embryo implantation. Cases involving multiple simultaneous issues, like Ms. Hiep's, are even more challenging and prolonged to treat.

Laparoscopic surgery to address abnormalities combined with in vitro fertilization is an effective method that has helped many women with uterine conditions and long-term infertility become mothers. Women experiencing these conditions should seek early consultation with an obstetrician-gynecologist or a reproductive specialist for screening for chronic endometritis, removal of polyps, and timely treatment of uterine fibroids to avoid the risk of infertility.

Hang Tran