Women’s Specialized Hospital, Saudi Arabia
Title: Successful pregnancy by transmyometrial embryo transfer after IVF in a patient with Congenital Cervical Dysgenesis
Dania Al-Jaroudi has completed her fellowship in Reproductive Endocrinology and Infertility and Reproductive Surgery at McGill University, Royal Victoria Hospital in 2004. She has completed her masters in Executive Masters for Health Administration from the University of Minnesota in 2014. She is currently a consultant in the Reproductive Endocrinology and Infertility Department at King Fahad Medical City in Saudi Arabia where she has helped in the establishment and inauguration of the Assisted reproductive unit, established the first national ART registry in KSA. She has a special interest in rare congenital anomalies affecting young women. She has published over 10 articles in her field.
Pregnancy in patients with congenital cervical hypoplasia after IVF is a rarity in reproductive medicine. Rock et al had published clinical management options among 30 young women with congenital anomalies of the cervix. Their conclusion was that it was advantageous to perform cervical reconstruction in patients with cervical dysgenesis. The aim mainly was to conserve the reproductive capacity. Other surgeons reported uterovaginal anastomosis in patients with cervical anomalies to preserve fertility. However, the complications of uterovaginal anastomosis should not be overlooked due to the reported complications of sepsis. We report a case of pregnancy by transmyometrial embryo transfer (Towako Procedure) after IVF in a patient with cervical hypoplasia with a fibrous band. The patient had presented to our unit seeking pregnancy. She had minimal cyclic abdominal pains with no evidence of hematometra. She had a history of amenorrhea. To the best of our knowledge, this is the first reported pregnancy in a patient with congenital cervical hypoplasia with a fibrous cord and bulbous tip after transmyometrial embryo transfer without prior uterovaginal anastomosis.