Background: Assisted reproductive technologies are making it possible for women to conceive when it was otherwise impossible. One of the side effects is multiple gestations. This may be especially disadvantageous when it occurs within an anomalous uterus. Patient and Methods: A 36-year-old women with the help of gamete intrafallopean transfer conceived triplets in a uterus didelphys. This pregnancy was further complicated by anencephaly of one of the triplets. The patient was managed by a combination of chorionic villi sampling and selective reduction that ended with the successful delivery of a term infant. Conclusion: Pregnancy reduction can be safely performed in a twin pregnancy on one side of a uterus didelphys. More reports will be required to determine whether this is the most optimal choice.
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