An abdominal ectopic pregnancy following a frozen-thawed ART cycle: a case report and review of the literature

Abstract

BackgroundEctopic pregnancy (EP) occurs in 1% of pregnancies and is reported to be more common in in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) pregnancies. An abdominal ectopic pregnancy (AEP) is a rare form of EP, and there are few reports of an AEP after IVF/ICSI. In this case report, a rare case of AEP after frozen-thawed cycle of ICSI is presented.Case presentationAfter a frozen-thawed cycle of ICSI, the beta-human chorionic gonadotropin (HCG) level at 4 weeks 0 days of gestation was 3.4 IU/L. Subsequent dysfunctional uterine bleeding was mistaken for menstruation; however, an AEP of 9 weeks with a fetal heart beat was observed by ultrasound. After the AEP was observed by ultrasound, it was extracted laparoscopically.ConclusionA rare case of an AEP, which developed after frozen-thawed cycle of ICSI, presented with a very low serum HCG level. Even if the HCG titer is low, follow-up HCG levels and frequent medical examinations are necessary.

Rectal ectopic pregnancy after in vitro fertilization and embryo transfer: A case report

“…[ 6 ] An increasing number of studies have shown IVF is one of the risk factors leading to abdominal pregnancy. [ 7 – 9 ] Although a majority of pregnancy could be visualized on TVS, ultrasonography alone is rarely used because yolk sac do not develop to this stage and exceedingly rare abdominal pregnancy may not identified. [ 10 ] Thus, it is important to monitor the serum β-hCG level.…”

“…[ 13 , 14 ] And there were 3 similar abdominal pregnancies from 2000 to 2020 (Table 1 ). [ 9 , 15 , 16 ] These cases have common characteristics: the history of IVF failure and the delayed serum β-hCG rise. It is suspected that a small number of embryos may lead slower proliferative activity of the trophoblast tissue and the abnormal implantation site may cause the poor absorption of β-hCG into the blood circulation.…”

Abdominal ectopic pregnancy following a frozen embryo transfer cycle: a case report

“…As reported, a poorly implanted or dying ectopic pregnancy may be present, in consequence of which the pregnancy test may be negative [ 10 ]. Another rare case presented with a very low serum β-HCG level of 3.4 IU/L was also reported to develop an AEP after hormone replacement frozen-thawed cycle [ 11 ]. A woman was also reported having undetectable serum β-hCG 9 days after blastocyst transfer, and was then diagnosed with a ruptured AEP and intra-abdominal bleeding 19 days later [ 12 ].…”

Manejo expectante de gestación ectópica abdominal tras fecundación in vitro en paciente con salpinguectomía bilateral. Reporte de un caso.

“…La presentación clínica de las gestaciones ectópicas suele resultar muy inespecífica 10 . Actualmente la ecografía transvaginal es el método más sensible y específico para el diagnóstico precoz del embarazo ectópico 11,12,13 . La combinación de la ecografía transvaginal con la determinación de β-HCG nos permite establecer el diagnóstico de forma más temprana y precisa, así como orientar la actitud terapéutica en cada caso 14 .…”