Triplet pregnancy and successful twin delivery in a patient with congenital cervical atresia who underwent transmyometrial embryo transfer and multifetal pregnancy reduction

Objective: To report an unusual case of congenital cervical atresia and tubal factor infertility, achieving triplet pregnancy through transmyometrial embryo transfer (ET) resulting in the delivery of healthy twins after multifetal pregnancy reduction (MFPR). Design: Case report and literature review. Setting: University hospital. Intervention(s): Controlled ovarian hyperstimulation, oocyte retrieval, in vitro fertilization, transmyometrial ET, MFPR procedure for triplet pregnancy. Patient(s): A 33-year-old patient with endometriosis-associated and tubal factor infertility who underwent uterovaginal canalization surgery for congenital cervical atresia 9 years ago. Main Outcome Measure(s): Successful delivery after transmyometrial ET followed by MFPR. Result(s): A total of three IVF cycles and four procedures of transmyometrial ET were performed. In the third cycle a triplet pregnancy was achieved. MFPR was performed 35 days after embryos transfer, two healthy babies delivered at 31 weeks gestation. Conclusion(s): With aggressive therapy, successful pregnancy is possible in similar patients. (Fertil Steril (R) 2009;91:1958.e1-e3. (c) 2009 by American Society for Reproductive Medicine.)