Progesterone hypersensitivity is a rare phenomenon which can occur after both endogenous and exogenous exposures. We present a case of hypersensitivity to various forms and routes of exogenous progesterone. A 27-year-old female presented with primary infertility. Investigations revealed Grade 1 endometriosis and polycystic ovary syndrome. Three cycles of intrauterine insemination were attempted which were unsuccessful and in vitro fertilization was proceeded. Six blastocysts of Grade A were formed and cryopreserved. Artificial cycle was used for endometrial preparation for frozen embryo transfer (FET). However, due to failure to use exogenous progesterone due to hypersensitivity reaction, Modified Natural Cycle (MNC) was used. A follicle was formed using ovulation induction with tamoxifen and human menopausal gonadotropin. Ovulation was induced by human chorionic gonadotropin (hCG), and natural progesterone from corpus luteum was used. FET was done when endometrium was 8 mm. Pregnancy was confirmed by transvaginal ultrasound and β-hCG levels and continued uneventfully. Endogenous progesterone can be used as an alternative for endometrial preparation for FET in patients with exogenous progesterone hypersensitivity.
Here, we report a rare case of abdominal pregnancy after left-sided proximal tubal occlusion and right-sided salpingectomy. A 28-year-old patient came to us with a history of primary infertility. On investigations, left mid-tubal block and right hydrosalpinx were seen. Laparoscopic right salpingectomy with left proximal tubal occlusion was done. In vitro fertilization was done, but result was negative. One and a half months later, the patient presented with amenorrhea of 6 weeks and Transvaginal sonography showed gestation sac in the left adnexa. Emergency laparoscopy was done. The left tube was skeletonized after adhesiolysis, but no pregnancy was seen in the tube. Gestational sac was identified in the lateral pelvic wall. Severe bleeding was encountered during removal and sac was finally removed after laparotomy. Histopathological examination (HPE) of the tube showed endometriosis and HPE of the sac showed trophoblastic tissue without any ovarian tissue. The absence of ovarian tissue in HPE of sac confirms this case as abdominal pregnancy.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.