Simultaneous Bilateral Tubal Ectopic Pregnancy after Intracytoplasmic Sperm Injection and Embryo Transfer, in a Patient with Stage 3 Endometriosis
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This case report details a simultaneous bilateral tubal ectopic pregnancy in a 32-year-old patient with stage 3 endometriosis following intracytoplasmic sperm injection and embryo transfer.
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Abstract
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- Mère-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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