Simultaneous Bilateral Tubal Ectopic Pregnancy after Intracytoplasmic Sperm Injection and Embryo Transfer, in a Patient with Stage 3 Endometriosis
2016
Objective: To describe a simultaneous bilateral tubal
ectopic pregnancy after intracytoplasmic sperm injection
and embryo transfer: A case report.
Setting: Department of Reproductive Medicine, Femme-
Mere-Enfant University Hospital, Bron, France.
Introduction: The incidence of extra-uterine pregnancy
increases to 2% to 12% following IVF-ET; several
pathogenic theories have been suggested, including
abnormal hormonal secretion or exogenous hormones
administered in assisted reproductive technology (ART).
Patient and method: A 32year-old nulliparous woman,
with primary infertility and endometriosis stage 3, was
treated by ART with intracytoplasmic sperm injection and
embryo transfer.
Result: The patient showed simultaneous bilateral extrauterine
pregnancy, managed by laparoscopic
salpingectomy.
Discussion: The various possible pathophysiological
mechanisms are described, with a review of the literature
on simultaneous bilateral extra-uterine pregnancy
following ART.
Conclusion: In pregnancies following ART, ectopic
pregnancy should always be screened for by serum hCG
monitoring and transvaginal ultrasound until the
implantation site can be confirmed, as incidence is higher
than in spontaneous pregnancy. Even if serum hCG
concentration increases normally, possible bilateral EP
should always be investigated if no intrauterine
gestational sac can be seen.
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