Tubal endometriosis as an insidious risk factor for tubal implantation in a procedure of assisted reproductive technique

Abstract Endometriosis is often associated with female infertility and exhibits a massive impairment in the physiology of uterine contractility that interferes with sperm and/or embryo movements. We present an unusual case of bilateral tubal pregnancy during an Invitro Fertilization-Embryo Transfer (IVF-ET) procedure in a tubal endometriosis patient. Bilateral tubal ampullary ectopic pregnancies, 20-30 milimeters in diameter were diagnosed during laparoscopic examination and bilateral salpingectomy was performed. Endometriotic implants were detected pathologically on mucosal surfaces of both tubes demonstrating the possible deleterious effect of endometriosis on embryo movement. Tubal mucosal environment containing endometriotic implants may behave like original uterine endometrium for ectopic tubal implantation of transferred embryos. However, we think that in order to decrease the probability for tubal implantation of transferred embryos; consideration of bilateral tubal closure or salpingectomy for patients with endometriosis before proceeding to an IVF-ET procedure may be useful. Keywords: Pregnancy, ectopic, endometriosis, embryo transfer Ozet Endometriozis cogunlukla kadin infertilitesi ile iliskilidir ve sperm ve/veya embriyo hareketlerini engelleyici, uterus kasilma fizyolojisinde belirgin bir bozulma ile kendini gosterir. Bir ender olgu olarak, Invitro Fertilizasyon Embriyo Transferi (IVF-ET) proseduru sirasinda, bir tubal endometriozis hastasinda bilateral tubal gebeligi sunduk. Laparoskopik degerlendirmede, 20-30 milimetre capinda bilateral tubal ampullada ektopik gebelik teshis edildi ve bilateral salpenjektomi gerceklestirildi. Endometriozisin, embriyo hareketini olasi geciktirici etkisini gosteren, endometriyotik implantlar her iki tupun mukozal yuzeylerinde patolojik olarak saptandi. Endometriyotik implantlarin olusturdugu tubal mukozal ortam, transfer edilen embriyolarin ektopik tubal implantasyonu icin orijinal uterus endometriyumu gibi davranir. Bununla birlikte, biz, bir IVF-ET prosedurune gecmeden once, transfer edilen embriyolarin tubal implantasyonu olasiligini azaltmak icin, endometriozisli hastalara bilateral tubal kapama veya salpenjektomi uygulamasinin goz onunde tutulmasinin yararli olabilecegini dusunmekteyiz. Anahtar sozcukler: Gebelik, ektopik, endometriozis, embriyo transfer