December 12, 2012

Case Report     

Mrs  XXX

Age 28yrs

Married Life-3yrs

Referred to us with

H/O of unable to conceive

3 failed IUI,  1st –June2012,  2nd –Nov 2012,  3rd-Dec 2012 :  All unsuccessfull due to ? cervical stenosis Planned for hysteroscopy-12/12/12

Intra-operative finding
1.False passage at posterior lip/wall of cervix

2.uterus acutely anteverted

3.uterine cavity was small and compressed due to fundal wall and lateral wall adhesion  – fundal and lateral wall metroplasty done and cavity opened up followed by  IUCD insertion
FOLLOW UP: Patient was called up for second look hysteroscopy with removal of iucd after next  cycle

SECOND LOOK HYSTEROSCOPY DONE ON 17/01/2013 

 

 

Intra-operative Finding
1.False passage in posterior lip/wall of cervix

2.cavity normal in size

3.IUCD removed
Video recording of hysteroscopy and digramatic representation of  uterus  and false passage was given to ivf specialist  following  which patient had embryo transfer in the same month (jan/2013) and had conceived twin pregnancy
Patient had embryo transfer in the same month(jan/2013) and had conceived twin  pregnancy  

 

Practical Points  
Acutely anteverted uterus may sometime lead to false passage and may be misdiagnosed/interpreted has cervical stenosis,tubular cavity,severe asherman
Hysteroscopy is the gold standard for diagnosis and mangament of such cases