Pregnancy Following Turners with streak Ovary

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.