I finally had my surgery this past Thursday. It was postponed because AF came last week and the doc didn't want to risk infection. Anyways, my fears were confirmed. I do have a unicornuate uterus. My doc said I'm only the 3rd female she's had in her 20 years of practice with this anomaly. My uterus is unable to carry a baby to term. So, now Inger and I are exploring other options, however my heart is broken knowing I will never experience the joy of being pregnant. I want to thank all of you for your support and kind words. I wish you all the best and lots of baby dust.
Kim

__________________
Kim 38 The one getting knocked up

Inger 42 The one who's knocking me up

Cycle #1
Cycle #2

Kim:

I'm so sorry about your situation. I used to frequent this board a lot when I was TTC, but don't come here much now that I've moved on to adoption. I understand what you mean about coming to terms with not ever bring able to carry a baby to term, as I'm in the same situation for unknown reasons (though it's probably my age). You are welcome to come to the adoption board on this site to explore this option if you're curious about adopting My being lesbian seems to be a non-issue for everyone else on the board.

I can assure you that, while I still have my days of disbelief that I will never carry a baby to term and I will never know what my biological children would look like, things do get better with time and I've pretty much come to grips with this unexpected turn in my life. In addition, I'm very excited about adopting a baby girl sometime in the next year!



Karen

__________________
Karen
DP Nancy
DS Jacob, born 2/20/05
DSS, 19
TTC 3+ years
Adopted Jacob after 4mcs, 2 operations, and more clomid, injectables, and IUIs than I care to remember
6/14/04--First meeting with agency
2/21/05--matched with Jacob, born 2/20/05
2/24/05--Gotcha Day!
3/7/06--Finalization of Jacob's adoption

Jacob loves his "at." The feeling is mutual.


My very short blog

Karen, thank you for your encouragement. I actually have seen you on the adoption board (I visited there once). I'm not exactly sure what Inger and I are planning on doing. All I know is that I need some time to grieve the loss of becoming a bio mom. I have good days and bad, but there are so many times when I see a baby, or think about not being pregnant, and I just break down and cry. It's like I have no control over it and it really sucks! I have many close people in my life that are grieving with me, and I'm grateful for their support, but they aren't feeling the same thing that I am. I have to go now, but good luck on your adoption, and if that is something we will consider, I'll definitely look you up on that board. Take care.
Kim

__________________
Kim 38 The one getting knocked up

Inger 42 The one who's knocking me up

Cycle #1
Cycle #2

I am so sorry that you found out what was going on and that it wasn't good news . I hope that you will be able find another option that can work just as well. Too bad surrogacy was so expensive!! Good luck in all your endevors!!

__________________

Never give up. There are many success stories in internet. Not many doctors know about this problem because is not fercuent. I suggest you to look in internet for succes stories.
Here I send you some
Tere






http://home.earthlink.net/~hrair/ourstories.html

Our Stories


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My Story

I was diagnosed with unicornuate uterus in March of 1996 by my fertility doctor. After undergoing a series of infertility tests a hysterosalpingography was performed and that is when I was told of my anomaly. I underwent laparscopic surgery to remove a left rudimentary horn and fallopian tube. My left ovary was not removed. The surgery although painful, was successful. From all the things that I have read, it seems that surgical removal of the non-communicating horn, helps makes it possible to conceive and to carry a pregnancy.

I became pregnant in March of 1997. I was referred to Dr. David Garry, a perinatologist from Wintrhrop University Hospital in Mineola New York. I had many ultrasounds done to make sure the fetus was growing and striving. I had two urinary tract infections one at 16 weeks and one at 28 weeks which brought on contractions. I was lucky that bed rest and lots and lots of water helped in both situations. But the UTI's did not come from the anomaly. At 34 weeks and at 36 weeks I again started having contractions but taking it easy and drinking more water helped both times. The contractions both times were brought on by uterine irritability which could have been caused by the anomaly. My water broke at 37 weeks but I didn't go into labor. My doctor tried to induce labor but it didn't work. For the next two weeks I went for non-stress tests and ultra sounds to make sure that the baby was doing fine, which she was. At 39 weeks and a few days my water ruptured and I went into labor. After a total of 50 hours, on December 14,1997 at 3:45 a.m. our daughter was born.

Her name is Olivia Ann. She was 7.7lbs, 21.5 inches long, a healthy full term baby, pretty good for a half a uterus. My husband and I call her our little miracle. It was not an easy pregnancy and I don't think I could have made it to term without the support of my wonderful husband and my caring doctor. I wish for all of you with this anomaly a little miracle of your own.

-Barbara



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Jennifer's Story

I am 29 years old and have a unicornuate uterus. Ten years ago I decided I wanted my tubes tied because I was no longer able to take the birth control pill. I thought at the time that getting my tubes tied was a good idea because I knew condoms were much less effective at preventing pregnancy than the pill, and I had never used condoms anyway and didn't really want to. My doctor told me that I would have a 75% chance of getting pregnant later on in life after having a reversal. I now regret making the decision that I made.

After the surgery to ligate my tubes, I was told I had only one ovary and one fallopian tube. This lessened my chances of having a successful tubal ligation reversal. They didn't find the unicornuate uterus then.

I got married a couple of years ago and had the tubal ligation reversal in August of 1996. The surgeon who performed that operation told me I had a unicornuate uterus, but didn't make a big deal out of it, all I knew was that my uterus was small. I didn't think about it again until I had a hysterosalpinogram last year. The doctor saw the shape of the uterus and told me that it would not affect fertility, but would increase my chances of early delivery. She didn't really make a big deal out of it either.

Since then I have learned that my condition is very rare and most doctors, even my fertility specialists, know very little about it. The doctor I am working with has worked with thousands of women and has only come across one other case like mine in her entire career! In some of the articles I have read in your site, it seems to suggest that a unicornuate uterus does cause infertility, but it seems to me there really isn't any evidence for this.

No one knows how many women have this condition, so it can't be determined if women with a unicornuate uterus are more likely to have fertility problems than those who don't. I never would have found out that I have this condition if it weren't for my surgeries.

An ob-gyn I saw recently told me I should have an ultrasound performed to see if I have two kidneys. I did, and yes, they are both there. I am glad for that!

Anyway, after a year and a half of trying to get pregnant with one scarred but functional tube and ovary, my husband and I have decided to try IVF. We are in the middle of our first cycle and will be having the egg retrieval and embryo transfer in a couple of weeks.

All of the doctors I have seen have told me that a unicornuate uterus does not affect fertility at all, nor will it increase my chance of miscarriage. Although I don't think they really know that for sure, because so little is known about it, I understand that a unicornuate uterus is simply half of a uterus. One half of my reproductive system simply didn't develop. I don't see any reason why it should interfere with the implantation of an embryo, or with any other part of a healthy pregnancy.

However, it does increase the probability that I will have a premature delivery, because there is less room in my uterus than in a normal one. For this reason, the IVF specialist I am working with has recommended we only transfer one embryo at a time. Usually when undergoing IVF multiple embryos are transferred to increase the chance of success. But in my case, a multiple pregnancy is too risky, so we are going to transfer only one at a time. It doesn't decrease my overall chances, only the chance that I will get pregnant pregnant during one particular cycle. We are fortunate to have IVF covered under our health insurance, so it won't cost us any more to keep trying.

Sincerely,
Jennifer



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To read Lisa Weartz's Story.

Please go to the wonderful pages of The Weartz Family Home Page



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Inez's Story

I was diagnosed with a uu via a laparoscopy 11 years ago. I have 1 fallopian tube and ovary on the left side. There had been no hint prior to this that I might have any trouble conceiving. I have regular 26 day cycles and no abnormal bleeding. The consultant suggested that I have an X-Ray to confirm if there were any other kidney related issues as this is apparently associated with a uu. The X-Ray confirmed that I also only have 1 kidney on the left side (again no other symptoms). At the time, the consultant told me that there was no reason why I shouldn't conceive and go on to have a healthy pregnancy. When this didn't happen, I had a multitude of tests (blood, chromosome, follicle tracking etc. - you name it I had it!) Nothing abnormal was found.

After 2 years, I did actually become pregnant, but before I even got used to the idea, I had a miscarriage. When this happened again 12 months later, I went to see the consultant again. He told me that early miscarriages are not associated with uu's and that it was just 'bad luck'. When I miscarried for the 3rd time, I didn't believe in that much bad luck. Again, I had a number of tests to establish if there were any problems. Again, nothing was found. In each case, a baby did not develop in the gestational sac - called a blighted ovum. During my 4th and 5th pregnancies I was treated with progesterone and HCG injections. This had no effect. The longest I went between conceptions was 2 years and the shortest 7 months. After this, I decided to forget about the whole thing and just live life to the full. I lost 2 stone in weight and totally changed my diet. I then found out I was pregnant again in August 97. I decided that this was definitely the final attempt! I declined the injections again and carried on as normal, even riding my horse. When I made it past 12 weeks I couldn't believe it! I had a total of 9 scans throughout the pregnancy and had steroid injections from 25 to 35 weeks as my consultant told me that delivering prematurely is associated with a uu. I finally delivered Alexander Christopher at 06:14 on the 10th April 1998 (full term 40 weeks), via an emergency c-section (nothing to do with the uu). He weighed a healthy 7lbs 3 oz.

Inez

Never give up.

http://home.earthlink.net/~hrair/ourstories.html

Our Stories


Denise's Story.

This is my story about my unicornuate uterus. I was diagnosed in June 1996. We had been married for 6 years and had never used birth control. I was 25. My ob/gyn ran all the usual tests. The hystersalpingogram showed the UU and blocked tube. He performed a lap which showed severe adhesions, missing right ovary tube, and hydrosalpinx of the left tube. He referred me to the RE, telling us that IVF was our only chance. The RE sent me for an IVP which showed I was also missing the right kidney. In July of 1997 the RE did another lap to removed the enlarged tube to give me the best chance of a successful IVF.

We began our first IVF in August of 1997. After I began the stimulation drugs, the daily ultrasounds showed that I did have a right ovary, but it was located where the kidney should be. It worked wonderfully and produced over 30 follicles. With so many follicles, I had to go to retrieval a day early. The left ovary was aspirated the conventional way, but with the right side, they just stuck the need straight through my ribcage. It was extremely painful, and after 3 attempts, they could only get 6 of the eggs. With the 12 from the left ovary, we ended up with only half of the eggs I had produced. Of those 18, only 7 fertilized normally because most were immature.

That cycle failed. In January of 1998, we did an FET which also failed. Both times, I had a decent lining (although not great) and no real explanation for the failures. We will attempt another fresh cycle in Oct/Nov 1998 using IVF/ICSI/AH. If that does not work, we'll use a surrogate and transfer any frozen embryos we get to her in Dec. '99 or Jan of 2000. The surrogate we want is currently pregnant.

We attempted a private adoption in June of '98, but the baby was born prematurely and died shortly after her birth. That tragedy prompted us to try IVF one more time.

In November 1998 we attempted another IVF/ICSI/AH. This time we got 7 good looking embryos and transferred 3. We were thrilled to finally get a positive beta test! I could not believe it. That morning, I went in for the blood draw. I knew the clinic rarely called back before noon, so I did some shopping. When I got home I had a message on both my home and work machines. I shook as I called them back. I called and the nurse, who I knew quite well, put me on hold. A few minutes later, my RE himself picked up the phone. I thought for sure he was going to give me bad new yet again. Then I heard those words -- "congratulations Denise, your test was very positive" I just burst into tears. My beta tripled a few days later and I felt so incredibly happy that this had finally worked. I got OHSS and went to the RE's office a few days before my normal scheduled ultrasound. I did not expect them to perform one then and my husband was not there. I called him at work and asked if he could come over quickly as I did not want him to miss our first u/s of the baby. We waited and waited and he did not show up, so I went ahead. We found not only one little fluttering heartbeat, but two! It was identical twins. I was just elated! The RE put me on bedrest for the OHSS. My husband met me going out. I could not wait to tell him the wonderful news. At the next ultrasound, we still had 2 good heartbeats, but we discovered that the twins were monoamniotic. This is a condition where both babies share the same amniotic sac. It's rare and usually ends it miscarriage of both babies. At the 9 week ultrasound, we saw that the babies had grown, but neither had a heartbeat. That was December 15. The next day my grandmother died. I had to go her funeral still carrying my babies and tell everyone who congratulated us that they had died. It was the absolute worst time of my life. I had a D&C the next week.

A few months later my husband received a promotion and we moved to the other end of the state. He received another promotion exactly one year later that brought us back home. We considered doing an FET, but I was too scared of another failure or loss. I did want to go through that again. Finally in October of 2002 we got the bill for our 4 remaining embryos. I decided I was ready to go ahead and use them. They had been frozen for 4 years and I felt like I needed to use them before I got too old. My husband assumed it would not work and said we'd just try to adopt again. The day before Thanksgiving 2002 we transferred the 3 embryos that survived the thaw. The week before, my husband was offered another promotion 2 states away. He took it assuming I would be joining him in a few weeks. 2 weeks later we actually had another positive beta test. This time, there was one little perfect baby growing in there. I had to call my husband since he had started his new job a few days after the transfer. He came home for each Dr's visit and ultrasound, but I wanted to stay near my trusted doctors. I ended up working for my entire pregnancy and living alone. DH hated missing it, and I hated that he was gone. Finally, on 8/8/03 our daughter was born via scheduled c-section. She was breach and during the surgery, my ob discovered why I had had such an easy pregnancy. My UU was missing the myometrium. That is the muscle layer that would cause cramps and contractions. I could hear him and the other doctors sound very serious while they were sewing my back up and it took nearly 2 hours. He told me he would explain it to me after he was finished. It turns out that they almost had to remove the UU due to severe bleeding. Normally, after birth the uterus contracts to stop the bleeding. Mine does not have that ability. Finally he sewed it up like a rump roast (his words) to get it stopped. I did not care one bit. I had my beautiful perfect little daughter. Paxtyn Faith was born on 8/8/03 weighing 7 lbs 4 oz. We came home from the hospital on our 13th wedding anniversary. We moved and joined my husband when she was 3 weeks old. He received another promotion 1 month before her first birthday, so we have now moved again, but plan to stay here at least 3 years.

Now we plan to travel back to our old clinic and start trying to have at least one more baby.

I want to thank Barbara for setting the site. I have searched for info on UU's for many years and have found almost nothing helpful till now. At least the stories I have read here give me hope that I can get pregnant and carry our baby to term.

Denise

More...



Becky's Story:

I was diagnosed with my UU with HSG, and confirmed with MRI in the spring of 98. I was 39 years old at the time. I have a left UU with both ovaries, and tubes and a very small rudimentary horn that contains no endometrial tissue. I also have two normal kidneys. This diagnosis was made while looking for a reason for my left sided pelvic pain.

I will back up a few years now to my childbearing days. I remember during my first gynecological exam the doctor remarked that my uterus was small, but that was about it. I got married in 1981, at age 22, and conceived for the first time in 1983. I had no trouble conceiving, and I carried almost to term, delivering at approx. 37weeks. My son was 6lbs 7oz, and healthy. The reason for the early delivery, was that my water broke, so they induced labor. When my son was approximately 18 months we decided to try to have another baby. This time things did not go so smoothly. After about a year of trying I consulted a gynecologist who specialized in infertility. He did all the usual tests including HSG, lap, hysteroscopy, and hormone studies. Everything seemed normal, except for my HSG. The HSG report said that I had a possible bicornuate type uterus, which my doctor dismissed, stating that I couldn't possibly have that since I had carried one child almost to term(I guess he was wrong). He said that my right tube was blocked and had a bulge in it, other than that there was nothing wrong(the bulge turned out to be my rudimentary horn) He gave me a diagnosis of "Unexplained secondary infertility." I did try a couple months of clomid, but did not feel right about it. I figured if there was no reason for me to be infertile, then why was I taking fertility drugs? Anyway I stopped that treatment and just took a break from it for awhile. After a few months I decided to try the next line of fertility drugs, I think it was pergonal at the time. While waiting to get my period to schedule the treatments for that cycle, I found out that I was pregnant. This pregnancy was uneventful, and actually went post term to 42 weeks. My daughter was a healthy 8lbs, 2oz. After this we decided not to use any birth control because we wanted more children, and figured that if it happened sooner than expected that would be OK. As it happened, I never got pregnant again. I thought about going to a fertility doctor, but the first time was such a bad experience, that I just decided to let nature decide about this one. After 8 yrs of trying, I decided that I was getting to the point where I wanted to be done with the monthly upheaval of wondering if I was pregnant or not, so we took steps so that I would be sure we would not conceive.

About three years ago, I began having increasingly painful periods. And was concerned because all the pain was on my left side. I had had cramps before, but this was different, and getting worse. It would start about a week before my period, and then peak during the first couple days of menstruation. After several changes in doctors I ended up seeing an RE. After all the testing showed no reason for my pain, the doctor agreed to do a laparoscopy. I had this procedure in December of 98. I also had a tubal ligation at the time. After the surgery he told me that I had a small cyst on my left tube, and an adhesion, but other than that everything looked fine. Then he said that he was not sure but he thought that my uterus appeared enlarged. He said it would be normal for a woman with a normal uterus after having children, but that he thought mine should be smaller because it is a UU. He thinks that what I have is adenomyosis(where the endometrial tissue grows inward in the muscle wall of the uterus) The only way to diagnose it is with a hysterectomy, and that might be where I am headed. I don't know if my UU has anything to do with this problem.

I hope that my positive pregnancy experience gives some of you hope. If you would like to email me please feel free to do so at Becky



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Gina

I successfully got pregnant, after three miscarriages, in November of 1996. I had a pretty normal pregnancy with slight spotting here and there through out the first trimester and plenty of "Braxton Hicks" contractions during the third trimester. I mentioned the contractions to my doctor and told him that only half of my uterus was getting hard. He reassured me that the baby was in a comfortable place and that there was nothing to be concerned about. By 33 weeks of pregnancy, I had been experiencing a very strange discharge that seemed to be very thick and very different from the norm. I was again told that this was all normal. Then, at 34.5 weeks, I was rudely awakened by a huge gush of liquid that poured out of me. I called doc and went to the labor and delivery room right away. Indeed my water had broken and the baby was being born prematurely and in a breech position.

I was taken in for an emergency c-section because the baby was trying to come down the birth canal knees first. While performing the c-section, my doctor noticed something looked a little strange about my uterus. He told me later that it looked to be tilted or deformed

All went very well with the surgery and my daughter was born weighing 4lbs 2oz and 15.5 inches long. She was very healthy and received an 8 and 9 on her Apgars. She came home with me 4 days later and has had no problems at all.

I was finally diagnosed with a unicornuate uterus in 1998 through an HSG. It revealed half on the left side, two tubes, one ovary properly positioned and the other ovary behind the uterus. The ill placed ovary was still questionable as we did not know if it worked or not. I never had a problem getting pregnant but there may have been a problem carrying. We are still not sure if my preterm labor was due to the uterus or the cervix.

I have since lost another pregnancy at 17weeks, which had nothing to do with the UU and I am currently pregnant again. I am now 18weeks pregnant and I am considered very high risk. I will be placed on steroids beginning my 25th week to help develop the baby's lungs and I am being monitored every other week via ultrasound. My due date is Jan. 12, 2000 but doc believes I should look closer to the middle of December for our new arrival.

I am very confident in this pregnancy and I know I am in the best possible hands. I look forward to posting our birth story in the near future.

Gina



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MY name if Pamela Codey, my husband and I started "trying" to have a baby in November of '97--we were so excited when I got pregnant in December. Told our families and at 8 weeks, miscarried. When the OB performed the D&C, he mentioned to my husband, Patrick, that my uterus seemed to be "tilted". He suspected it may be a Unicornuate uterus, but didn't think we needed any tests and told us to try again and see what happened. Well, my cycles were running 6 weeks long and it bothered me that he said --"something might be wrong, but lets see what happens." I felt that we should look into this UU. I changed doctors in July and my new doctor sched me for a transvag u/s-- this showed that I had a very very small uterus, but they couldn't make out the shape. I was then scheduled for an HSG. 3 days before the sched HSG, I took a pregnancy test. They advised me to, just to make sure before the test-- and much to my shock-- it came out positive!! (It was September 21st, ironically, the due date of my first pregnancy.) We were very shocked b/c I had what I thought was my period the week before. They did blood tests to check levels every other day- They doubled as they should. They did internal u/s at 5 weeks and couldn't see anything. Another at 6 weeks-- there was no heartbeat, only a y shaped uterus. The following week was another u/s and with the transvag u/s, they showed us our baby's heartbeat!

I spotted often during my pregnancy-- but all continued to go normally.

When I would be out at the mall or somewhere walking, I would tire and cramp quickly.

At 34 weeks I had an u/s b/c I have a pelvic kidney ( also related to uu) and they wanted to make sure it would allow me to deliver-- or if it were in the way, they would sched a c-section. Well, at this u/s they told me my cervix was very short and they did an internal to find that i was contracting, 2cm and 70%effaced. They gave me a steriod shot for the baby's lungs and put me on bedrest. The next morning I woke up with contractions-- went to the hospital and had progressed to 3 cm. They gave me another steriod shot and stopped labor with tribuline.

Almost everynight I had contractions, but, they would stop -- two weeks later, April 28, 1999...I woke up and called the doctor-- I had contractions-- strong contractions all night-- he told me to come to the office. When I got to the office, he said "You are 7 cm and 90% I'll see you at the hospital." He broke my water around 12:30 in the afternoon and I had the baby at 3:37pm. It was a 6 lb baby girl. Keira ilene. She scored 8 and 9 on her Apgar testss. She was 4 weeks early but doing very well.

I am happy to say that she is now 15 weeks old and her pediatrician said he doesn't think of her as a preemie, b/c she is right where a 15 wk old should be. I love motherhood and want to say that every scare and test was worth my reward. Keep trying and keep the faith!!!!

Have a Nice Day!

Pamela Codey
Customer Financial Services
Southwest Region

Even Twins....

http://home.earthlink.net/~hrair/unicorn.html


Unicornuate


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The following article is an excerpt from the article called "Successful Delivery of Twins in a Woman with a Unicornuate Uterus" written by Dr.Jerome H.Check, Grace Lee, Kosrow Nowroozi and Amy Baker. This article has been used without permission and is for information purposes only. For a reprint of this article contactLaurie Aurand, Reproductive & Medical Endocrine Assoiciates, P.C., 7447 Old York Road, Melrose Park, Pennsylvania 19027
Abstract

The presence of a unicornuate uterus is a rare congenital condition which represents only 1-2 % of uterovaginal anomalies. Previous reports have demonstrated an increase in the number of cases of primary infertility, pregnancy loss and preterm labor associated with the unicornuate uterus. Herein, we present a case in which a patient conceived following a thawed frozen embryo transfer. She had been given the option of selective reduction, because of the high risk associated with this pregnancy, but refused and her pregnancy successfully continued to 35 weeks and delivery of twins.

INTRODUCTION

A unicornuate uterus is a rare congenital anomaly representing 1-2% of all uterovaginal anomalies. Poor reproductive function is frequently associated with this condition. A greater incidence of primary infertility, pregnancy loss and preterm labor has been reported with congenital uterine anomalies. Unicornuate uteri, in particular, have shown the highest rate of primary infertility (15%) and the poorest fetal survival (40%). The management and outcome of a patient with a left unicornuate uterus and a twin gestation is discussed. The unicornuate uterus is a rare diagnosis. Andrews and Jones were able to find only 8 women with this diagnosis in their entire infertility and obstetric practice at Norfolk General Hospital and Johns Hopkins Hospital between 1969 and 1981. This defect is considered to represent about 1 -2 % of all uterovaginal anomalies. A review of the literature from 1959 to 1983 showed that in 119 pregnancies in 50 patients with unicornuate uteri, there was a spontaneous abortion rate of 33%, a premature delivery rate of 29%, and a live birth rate of 66 % , whereas another study estimated fetal wastage to be 31% . The management and outcome of a pregnant patient with a unicornuate uterus and a twin gestation is described herein.

Case Report

A 29-year-old nulliparous white female presented with the complaint of primary infertility of 4-year duration. The patient who had a history of anovulation was treated with human menopausal gonadotropins (hMG) for 3 months without achieving a pregnancy. She was known to have a Ieft unicornuate uterus from a diagnostic laparoscopy1 year before. More recent laparoscopic findings revealed fimbrial agglutination of the left fallopian tube, congenital absence of the proximal portion of the right oviduct, and the presence of both ovaries. Hysterosalpingography showed a smaller than usual uterine cavity. Intravenous pyelogram showed medullary sponge kidneys with no other abnormalities noted.

At this point, the patient was given the option of reconstructive surgery or in vitro fertilization. She elected the latter treatment. She underwent controlled ovarian hyperstimulation with hMG following pituitary suppression with leuprolide acetate. During her first cycle, 21 oocytes were retrieved transvaginally from 27 folllicles. Twelve oocytes fertilized, 5 embryos were transferred and 7 embryos were frozen (4-6 cells each) using a modification of the one-step technique. However, a pregnancy was not achieved at that time. Ovulation was subsequently induced with clomiphene citrate for a frozen embryo cycle. When two 19-mm follicles were present on the right ovary, human chorionic gonadotropin was given and 3 frozen embros were transferred. All 3 underwent cell division prior to embryo transfer. A twin gestation was documented by ultrasound at 6 weeks gestation. From 30 weeks gestation until delivery. the patient was on bed rest, Ibuprofen (2.400 g daily) was prescribed from 20 weeks until 1 week prior to delivery. At 35 weeks gestation, after a hospital stay and discharge of 24 hours, the patient returned to the hospital in labor. Ultrasound confirmed fetal presentations to be vertex-vertex. Twin A (male.2,400g,, Apgars 8/9) was delivered by spontaneous vaginal delivery. Twin B (male, 1,995 g. Apgars 4/9) was delivered by primary lower cesarean section after a cord prolapse with spontaneous rupture of membranes with the fetal vertex noted to be still high, umbilical arterial pH 7.17. The placenta with membranes was examined and found to be diamnionic dichorionic.

Conclusion

Improved pregnancy success rates following transfer of cryopreserved thawed embryos are expected with an increased number of embryos transferred. However, a decision on the number of embryos to transfer in both the retrieval and the frozen embryo cycle was necessary in this case, since there was concern that her unicornuate uterus would preclude a successful outcome if a multiple gestation occurred.

Unfortunately, after diagnosing twins by sonography, we could not find any reports in the English literature of multiple births in a unicornuate uterus to use as a precedent. The option of selective reduction was discussed with the patient. She was advised that we would have to consider her situation analous to a quadruplet pregnancy. We related our personal statistics involving 32 patients with high-order multiple gestations offered reduction to a minimum of twins where all 14 patients choosing selective reduction had a successful outcome (13 of 14 babies delivered) versus only 18 of 25 not choosing selective reduction delivered at least 1 live baby. Furthermore, there was a significant higher rate of prematurity in the latter group. Despite these data, the patient declined selective reduction.

There appears to be an inherent bias in conclusions made from literature surveys on the unicornuate uterus. Many were reported in women with a history of recurrent abortion, yet the viable pregnancy rate in women with uterine anomalies were compared to the expected outcome in normal pregnancies and not in habitual aborters. There are many who believe that the unicornuate uterus is more common than is thought and might not even compromise a successful outcome. Certainly, most would agree that the septate or didelphys uterus represents a much more serious threat than the unicornuate uterus.

A successful outcome in this case report does not prove that subsequent cases of twins in a unicornuate uterus will produce at least 1 viable baby. Thus, the option of selective reduction should still be presented. The case described herein, however, at least presents a precedent for success that was not available to this patient when she had to make a decision.



Unicornuate Uterus


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Hello Everyone, I just found this site while searching the net trying to find new info on UU. Mine was discovered tragically when my first pregnancy ended horribly. I had indeed gotten pregnant the only problem was my son took up residency in my non communicting horn. When I was 22 weeks along my horn ruptured and I nearly bled to death before they got me to surgery and discovered the cause. Now I don't want you guys to think I am here to scare you, because I am not! I had my horn removed of course but also my left ovary becasue it was attached to it. I have since had no real problem getting pg with only one ovary. I have indured 2 miscarriages after my first loss and then I was blessed in my 4th pregnancy to deliver another son. He was born 8 weeks early becasue of course the room just isn't the same as a normal uterus. I am currently Pg for the 5th time! I am about 11 weeks along and so far fingers crossed all is still going well. I've had 2 U/S already and have seen the heart beat and go back in 2 weeks for another.
I have been told that I also have a mutation referred to as MTHFR. which is bare with me methyl tetra hydrate folate reductase mutation which keeps my body from using folic acid properly and may have been a contributing factor in my miscarriages. That being said I hope all goes well during this pregnancy!

O.k. enough about that medical lingo crap. I just want you all to know that there is hope in having a baby with a UU. Don't let anyone tell you that you can't because obviously it is possible or there wouldn't be all these other ladies stories on here as well. I will tell you that my heart goes out to each and everyone of you. God Bless and Good Luck!





Re: Unicornuate Uterus
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I have a bicornuate one. It took me 8 months to get pg. I gave birth to a son almost a year ago. I was actually 8 days past my due date. Spotted a few times and legiment stretching hurts more than usual.

Over on Mom's and Dad's there is a lady that has one and she has successful pgncies. Her name is Tania.

Don't let all the bad things you read get to you. Stay positive. But the sad thing is, that you can never have twins. Uterus can't handle the growth (weight and length) and movements of two.
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Rachel (26) Brandon (25)
United in Marriage on August 24th, 2002
Proud Parents of Isaac David born February 24th, 2004
AND
Carson Eli born January 18th, 2006.