Fallopian tube block induced secondary infertility in a case of unicornuate uterus treated successfully: A long covid sequalae?

ABSTRACT

Infertility arising from infections is alarming cause of secondary infertility which is growing in number by the day. Mullerian anomalies can result in female infertility. A unicornuate uterus with a rudimentary horn is an abnormality induced by a faulty mullerian duct fusion. On Hysterosalpingogram, the uterine cavity has a spindle-shaped that tapers at the tip and drains in to a single oviduct. A 30 years old female with secondary infertility post COVID 19 infection, which upon investigated turned out to be unicornuate uterus with single fallopian tube on left side cornual block visualized in fallopian tube. All the causes of fallopian tube block including pelvic inflammatory disease, tuberculosis, trauma and bacterial infections were ruled out yielding COVID19 as the probable cause of infertility. Fallopian tube cannulation was done following which she conceived spontaneously. Elective encirclage done at 12 weeks and she was asked to report at 37 completed weeks for cervical stitch removal. After that emergency LSCS done. She delivered baby boy of 2.7kg with APGAR score 9/10. We concluded that angiotensin convertase enzyme 2 receptor were present on the fallopian tube might be responsible for post COVID fallopian tube blockage which is a topic for further studies. Prompt detection and management of long COVID sequelae in the form of infertility, particularly in predisposed people who are more likely to develop such difficulties, is thus critical to preserve infertility.