title: Successful tubal blastocyst transfer after laparoscopic cervical cerclage: cesarean delivery of a live very low-birth-weight infant and later hysterectomy for uterine rupture.
abstract: OBJECTIVE
  To report the management of a woman who presented with secondary infertility and amenorrhea after 2 Lletz procedures and a cone biopsy and who had cervical stenosis, a foreshortened cervix, and hematometra.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Fertility clinic and tertiary hospital.
  
  
  METHODS
  A 34-year-old woman who wanted further children but had had a previous cesarean delivery and then a cone biopsy for cervical intraepithelial neoplasia III that resulted in a foreshortened cervix and cervical obstruction.
  
  
  METHODS
  Laparoscopic cervical cerclage, IVF, blastocyst tubal transfer, cesarean delivery, hysterectomy.
  
  
  METHODS
  Pregnancy; morbidity for the woman and her infant.
  
  
  RESULTS
  An intrauterine pregnancy occurred after blastocyst intrafallopian transfer, but there was uterine herniation necessitating premature delivery of a very low-birth-weight infant that had lung problems but is now healthy. The mother later developed a hematometra that ruptured, requiring an emergency hysterectomy from which her recovery was protracted.
  
  
  CONCLUSIONS
  This first report of a blastocyst intrafallopian transfer was associated with an intrauterine pregnancy; however, when the indication for blastocyst tubal transfer of an obstructed cervix is associated with a foreshortened cervix requiring cervical cerclage, there can be major health risks for infant and mother.
authors.affiliation: Fertility Associates, Wellington, New Zealand.
authors.forename: Andrew
authors.initials: A
authors.lastname: Murray
authors.forename: John
authors.initials: J
authors.lastname: Hutton
mesh_terms: D000328:Adult; D023802:Cerclage, Cervical / Q000009:adverse effects*; D002585:Cesarean Section / Q000379:methods; D004624:Embryo Transfer / Q000379:methods*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D011247:Pregnancy; D014597:Uterine Rupture / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery