Rare case of intracytoplasmic sperm injection - embryo transfer twin pregnancy in a patient with unicornuate uterus

Tejal Poddar, Purnima Nadkarni, Aditi Nadkarni


Congenital uterine anomalies result from an abnormal formation, fusion or reabsorption of Müllerian ducts during fetal life. A 26 year-old healthy woman with history of 5 years of primary infertility. Her physical exam was completely normal, while a transvaginal ultrasound revealed a left unicornuate uterus and normal left ovary and fallopian tube, but the right ovary and tube could not be visualized and right sided ectopic kidney at the level of umbilicus was noted. Left kidney was in normal position. A diagnostic laparoscopy for her confirmed left unicorunate uterus with normal left ovary and tube along with rudimentary right horn and only about 2 cm proximal stump of the right fallopian tube. The couple underwent two cycles of ICSI because of male factor. First βHCG report was 349mIu/ml followed by second which was 2432.1mIu/ml. First ultra sound revealed biamniotic bichorionic twin live intrauterine pregnancies. A fetal reduction was planned at 11 weeks for fetus A due to increases NT>5mm which was completed uneventfully. Cervical length was measured at 18 -20 weeks which were merely 1.4cms. Hence McDonald’s cervical encirclage was performed. Cervical knot was cut and emergency cesarean section was performed at 35weeks gestation, and a 2.6 kg male baby was delivered uneventfully.


Congenital uterine anomalies, Müllerian ducts, unicornuate uterus, ICSI pregnancy, Embryo reduction, McDonald’s encirclage

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