38 year old lady presented with primary infertility with 17 years marital history. Patient menstrual history revealed irregular cycle. Had bleeding only after withdrawal medicine. She is a known case of hypothyroidism on treatment. USG showed small uterus with streak ovaries. Hormone showed AMH < 0.08, FSH-30.8, LH-8.04. Hysteroscopy showed small uterine cavity. Laparoscopy showed bilateral streak ovaries. KARRYOTYPE revealed XO.
Her partner SFA was normal. So we planned for her DO-ICSI. Her endometrium was prepared for 4 month and ET was done on 2014.Turned to be pregnant positive with β HCG value > 1500. To our surprise on USG, it was heterotropic pregnancy with intra uterine fetal demise and a partially ruptured left ectopic.
Emergency Laparoscopic salphingectomy done. Again started endometrial preparation for 6 month. ET done which was positive. This time she had intra uterine pregnancy. During Antenatal period she developed GDM, PIH with oligo hydrominas. Patient delivered an alive girl baby by caesarean section.