Lien, a young woman with a normal ovarian reserve, faced challenges conceiving naturally due to endometriosis. Last year, she underwent in vitro fertilization (IVF) at a hospital, which resulted in one failed embryo transfer and one miscarriage that required uterine aspiration. Following this intervention, she developed uterine adhesions, necessitating surgical treatment.

The couple sought treatment at the Center for Reproductive Assistance, Tam Anh General Hospital Ho Chi Minh City (IVF Tam Anh Ho Chi Minh City). Doctor of First Degree Specialist Nguyen Thi Thach Thao performed an ultrasound, confirming the presence of uterine adhesions. This was likely caused by the previous aspiration procedure, which damaged the uterine lining, hindering its ability to regenerate and causing the uterine walls to adhere and form scar tissue. The earlier surgical intervention had not fully removed these adhesions.

Doctor Thao performed a second hysteroscopic uterine adhesion lysis for Lien. A follow-up examination after one month showed good uterine recovery. The doctor then developed an ovarian stimulation protocol tailored for the patient, which resulted in the retrieval of 16 mature oocytes. Her husband also provided a sperm sample.

Embryologists selected viable sperm for injection into the oocyte cytoplasm, then cultured the embryos in a time-lapse incubator system that optimized conditions, resulting in 11 day-5 embryos. Artificial intelligence (AI) software graded all embryos as good quality.

Lien then received one month of endometriosis suppression treatment before one good-quality embryo was transferred to her uterus. She successfully conceived, and the remaining embryos were cryopreserved. Due to a short cervix, the pregnant woman faced a risk of preterm birth. Doctors at the Center for Obstetrics and Gynecology promptly performed a cervical cerclage to help maintain the pregnancy. Her pregnancy is currently at week 27 and is progressing well.

Embryologists observe embryo development through a time-lapse incubator system. *Photo: Thanh Luan*

According to Doctor Thach Thao, women can experience infertility due to various reasons. Cases involving multiple conditions, such as Lien's, require a multidisciplinary approach for complete treatment before embryo transfer and close monitoring throughout pregnancy.

For infertile women who conceive despite having a short cervix, it is crucial to rest, avoid strenuous activities, abstain from sexual intercourse, maintain a nutritious diet, stay hydrated, manage stress, and adhere to all doctor's instructions. Should symptoms like lower abdominal pain, vaginal bleeding, unusual vaginal discharge, or decreased/absent fetal movement occur, prompt hospital examination and intervention are necessary.

Hoai Thuong

*Patient's name has been changed