01
In May 2020, Ms. Deng came to the gynecology department of Shenzhen Luohu District People's Hospital for relevant physical examination due to the 7+ months of pelvic lump found during the physical examination, and the inspection report showed that the left ovary was small, and there was a ovarian cystic adenoma on the right side, with a size of about 48 *35*45mm. Hormone tips: fsh: 73.72iu/l, lh: 26.79iu/l, e2:22pg/ml, amh<0.01ng/ml.
Carefully understanding the medical history, Ms. Deng underwent "bilateral ovarian cyst dissection" in the laparoscopy in 2010, and the postoperative pathology suggested: bilateral ovarian junction endometrioid cystic adenoma. After the operation, a daughter was born vaginally in 2014, and in 2015, bilateral ovarian bordering cystic adenoma was removed. In 2017, she was pregnant for 2+ months and had a miscarriage.
In this regard, the gynecologist invited Dr. Wang Li of the Department of Reproduction to consult together to see if it was necessary to preserve the patient's ovaries.
Dr. Wang Li communicated with Ms. Deng, giving advice while fully respecting the patient's opinion. She told Ms. Deng: First, her ovaries are prematurely failing, and the sinus follicles are almost invisible. Second, even if the ovaries are not removed and the ovaries are treated after surgery, ovarian cysticadenoma may still recur. Third, even if there are eggs and embryos, the chances of pregnancy are greatly reduced, and the miscarriage rate is very high.
After careful consideration, Ms. Deng still decided to keep her ovaries, and her desire for a second child was more than anything. As long as there is a glimmer of chance, you still have to try, so that you will not regret it in the future.
02
Therefore, Ms. Deng performed uterine laparoscopy in our hospital under "right ovarian cyst dissection + pelvic adhesion release + intestinal adhesion release + hysteroscopy + diagnosis and scraping".
After the operation, Dr. Wang Li tailored the treatment plan for Ms. Deng and asked her to review the treatment effect after 2 months. In view of the fact that menstruation has been disordered for 3 months, Dr. Wang Li prescribed Fenma Tong Toning Menstruation + Vitamin E + Multivitamin + Three-dimensional B + Kidney Tonic Chinese Medicine for Conditioning. In response to mild calcium deficiency and elevated antinuclear antibodies, Dr. Wang Li prescribed vitamin D + calcium tablets + Chuang Le for treatment.
In September 2020, Ms. Deng returned to the Department of Reproductive Medicine of Luohu People's Hospital with great expectations to see Dr. Wang Li. After examination, Ms. Deng amh: 0.02ng/ml, fsh: 39.62iu/l, lh: 10.77iu/l, ultrasound prompt: occasional sinus follicles.
Her physical condition was slowly getting better, and Ms. Deng saw a little hope. Director Wang Li was also very pleased, under her guidance, Ms. Deng entered the IVF cycle, and they worked together for the second child.
03
In December 2020, Ms. Deng took one egg and cancelled the cycle due to the unfertilization of the egg. In January 2021, she was conceived again and cancelled due to the lack of eggs. After continuing the medication to condition the ovaries and conduct endocrine monitoring, during which the left fallopian tube was found to be hydrospent, Ms. Deng refused surgery.
In March 2021, on the third day of Ms. Deng's menstruation, b ultrasound prompted the follicle of 5*5mm on the left side, fsh: 39.45iu/l, lh: 13.84iu/l. After 6 days, the b ultrasound suggested that the left follicle size was 13 * 12 mm, and the hydrosalpinx appeared again, and Dr. Wang Li gave ovulation induction to retrieve the eggs and obtained a mature egg to form an 8-cell class I embryo.
Ms. Deng wanted to save a few more embryos for transfer, so she temporarily froze the embryo. However, the conditioning and monitoring of the next two months did not see sinus follicles, but instead the occasional hydropsal fluid appeared.
In this regard, Dr. Wang Li immediately made a decision and suggested that Ms. Deng first transfer frozen embryos, and if it fails, then slowly adjust the ovaries, Ms. Deng agreed to the suggestion.
04
On the 3rd day of menstruation, there was no hydrosalpinx, and Dr. Wang Li gave hormone replacement to adjust the lining.
On the 10th day of menstruation, left salping fluid appeared, and Dr. Wang Li told Ms. Deng whether to give up this cycle and start tubal ligation, because there is only one embryo, and there is only one chance.
Ms. Deng refused the operation after consideration. In this regard, Dr. Wang Li suggested that Ms. Deng go back to the jump rope to see if it helps, because the water in the fallopian tubes is also intermittent.
Unexpectedly, the ultrasound was followed up on the 15th day of menstruation, and no hydrosalpinx was seen.
So it was decided to transfer an 8-cell embryo on the 18th day, and 14 days after the transfer, the blood hcg: 1004.4iu/l was tested, indicating pregnancy.
Ms. Deng was excited, and she didn't expect that pregnant qi would care for her so much. She thanked Dr. Wang Li one after another and said, "Without your encouragement, I wouldn't have been able to hold out for so long." Thank you for letting me have the happiness of being a mother again. ”
Ms. Deng's efforts to ask for the baby Dr. Wang Li are all in her eyes, so she is sincerely happy for her. Ms. Deng is currently 8+ weeks pregnant.
1, try hard, stick to it may have a good ending.
2, be sure to cooperate with your attending physician treatment, every doctor is the same, want to try to help you, want you to have a good result.
3, an embryo should not be abandoned too little, because the real pregnancy is the one or two embryos.
Finally, I wish everyone a good pregnancy!