Fertility Files – Real Cases of Infertility Challenges

Recurrent Pregnancy Loss with Bicornuate Uterus Leading to Successful Euploid Embryo Transfer

They had already experienced two pregnancy losses naturally. When they visited us during their third pregnancy, the scan revealed another missed abortion. At just 27–28 years of age, the couple was searching for answers after repeated pregnancy loss. Further evaluation revealed conflicting reports between a septate and bicornuate uterus, making accurate diagnosis critical. With personalised IVF planning, PGT-A testing, and a carefully timed embryo transfer, the couple achieved a successful pregnancy with a healthy fetal heartbeat.

- Birla Fertility & IVF, Allahabad, (Dr. Madhulika Singh)

Case Snapshot

Patient Age Female: 27–28 years | Male: 27–28 years

ChallengesRecurrent pregnancy loss, bicornuate uterus, conflicting imaging findings, slow endometrial growth, financial limitations for embryo testing

TreatmentIVF with hysteroscopy evaluation, PGT-A embryo testing, personalised frozen embryo transfer (FET), single euploid embryo transfer

OutcomeSuccessful pregnancy with confirmed fetal cardiac activity

TimelineSeveral months with staged embryo testing and personalised transfer planning

Journey Timeline

1. Complex Challenges

2. Personalised Plans

3. Safe Retireval & Transfer

4. Guided Transfer

5. Successful Pregnancy

The Barriers They Faced

Recurrent Pregnancy Loss

Two previous missed abortions followed by a third pregnancy diagnosed as a blighted ovum at 8 weeks.

Conflicting Diagnosis

MRI suggested a septate uterus, while 3D USG and HSG findings pointed towards a bicornuate uterus.

Implantation Challenges

The uterine abnormality increased the complexity of implantation and pregnancy continuation.

Financial Constraints

Embryo testing had to be planned in stages due to budget limitations.

Slow Endometrial Growth

During FET preparation, the endometrial lining developed slowly and required extended monitoring.

Doctor's Quote

“The key was to tailor every aspect of care to this patient's unique needs, balancing safety, comfort, and clinical effectiveness.”

— Dr. Madhulika Singh

The Treatment Plan that made the Difference

Hysteroscopy Evaluation & IVF Planning

A hysteroscopy was performed to confirm the uterine anatomy, which established the diagnosis of a bicornuate uterus. IVF treatment was then planned accordingly.

Single Embryo Transfer Strategy

A single embryo transfer (SET) approach was chosen to optimise pregnancy outcomes and minimise additional risks.

PGT-A Based Embryo Selection

The first 5AA embryo tested through PGT-A was found to be aneuploid. Two additional embryos were later biopsied, resulting in one healthy euploid embryo suitable for transfer.

Personalised Frozen Embryo Transfer (FET)

Because of slow endometrial growth, the patient’s cycle required close monitoring and extended preparation. The embryo transfer was ultimately performed on Day 28 under optimised conditions.

Successful Euploid Embryo Transfer

A single euploid embryo was transferred successfully. β-hCG levels around 1300 on Day 14 confirmed a positive pregnancy.

A Story of Precision in Recurrent Pregnancy Loss Care

This case highlights the importance of accurate diagnosis in uterine anomalies and the role of PGT-A in improving embryo selection for recurrent pregnancy loss cases. It also demonstrates how personalised endometrial preparation and staged embryo testing, even within financial limitations, can help achieve successful outcomes. With the right combination of medical precision, persistence, and personalised care, even complex recurrent pregnancy loss cases can be managed successfully.

The Outcome

Ultrasound later confirmed a healthy 6-week fetus with cardiac activity.

The patient subsequently travelled for her UPPSC Mains examination with medical clearance and necessary precautions.