Extra-uterine pregnancy following assisted conception treatment

Abusheikha, Naim; Salha, O.; Brinsden, Peter

doi:10.1093/humupd/6.1.80

Cited by 36 publications

(19 citation statements)

References 147 publications

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“…The risk factors for HP are endometriosis, periadnexal adhesion, tubal surgeries, and ART procedures that include a transfer near the uterine horn, excessive pressure in the syringe during transfer, and an excessive number of transferred embryos [1,3,4]. A HP should be considered in women who have had ART, whose chorionic gonadotropin level increases continuously after dilatation and curettage or spontaneous abortion, whose uterine fundus is larger than predicted for menstrual dates, who have more than one corpus luteum in a natural conception, or in whom vaginal bleeding is absent in the presence of signs and symptoms of ectopic gestation [5].…”

Section: Discussionmentioning

confidence: 99%

A live birth after laparoscopic cornual resection for cornual heterotopic pregnancy after IVF-ET

Lee

Eom

Koh

et al. 2012

Korean J Obstet Gynecol

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A 28-year-old Korean woman with a history of both salpingectomies due to two prior tubal pregnancies at other institutions conceived a heterotopic cornual pregnancy after in vitro fertilization-embryo transfer. The patient was referred to the emergency department with an abrupt onset of lower abdominal pain at the 7th gestational week. We performed an emergent laparoscopic right cornual resection. The subsequent antenatal course was unremarkable. There were no obstetric or surgery-related complications. The patient delivered a healthy baby of 3,340 g via Cesarean section due to failure to progress at term. Copyright © 2012. Korean Society of Obstetrics and GynecologyHeterotopic pregnancy (HP) is a rare complication of pregnancy in which intra-uterine and extra-uterine gestation occur simultaneously. The prevalence rate of HP is as rare as 1 in 30,000 natural gestations but increases to 1 in 100 pregnancies in women who have undergone an assisted reproductive technology (ART) procedure [1]. The incidence of cornual HP is estimated to be as high as 1 in 3,600 in vitro fertilization (IVF) pregnancies [2]. Cornual HP has a high risk of uterine rupture and is difficult to diagnose early. The main issue in the treatment of a cornual HP is to be as minimally invasive as possible to preserve the developing intrauterine pregnancy. We report the case of a cornual heterotopic pregnant woman who delivered a healthy baby after a successful laparoscopic cornual resection for a cornual HP that developed after the women underwent IVF-embryo transfer (ET). Case ReportA 28-year-old Korean woman, gravida 2, para 0, underwent IVF-ET because she had undergone two prior salpingectomies for tubal pregnancies at other centers. She was referred to the emergency department because she had experienced an abrupt onset of lower abdominal pain at the 7th gestational week. At initial presentation, her vital signs were stable and physical examination of the abdomen presented lower abdominal tenderness and rebound tenderness. A transvaginal ultrasonogram showed free fluid in the cul-de-sac and two gestational sacs (Fig. 1). One gestational sac was present in the right cornual area and the other was in the uterine cavity. Two separate yolk sacs and fetal parts were noted in each gestational sacs, but there were no fetal heart tones. We performed emergent laparoscopic surgery including right cornual resection. To minimize exposure of the fetus to anesthetic agents, general anesthesia was started after completion of the preparations of all laparoscopic surgical instruments and operation-related procedures. After the trocar was inserted, carbon dioxide pressure was CASE REPORT Korean J Obstet Gynecol 2012;55(8):610-613 http://dx

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Section: Discussionmentioning

confidence: 99%

A live birth after laparoscopic cornual resection for cornual heterotopic pregnancy after IVF-ET

Lee

Eom

Koh

et al. 2012

Korean J Obstet Gynecol

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“…The estimated blood migration of transferred embryos towards the fallopian tube could explain the ovarian pregnancy after ET (1). The reverse migration could happen due to junctional zone contraction and strong endometrial waves in the fundal area of the uterus, which can be caused by the difficult ET, the manipulation with the tissue forceps, the high volume and pressure of the culture and the tilt-down position of the patient during ET (1,5). Some authors have reported fertilization of unrecovered oocytes if the coitus occurred near the day of the oocytes retrieval (1).…”

Section: Case Reportmentioning

confidence: 99%

Ovarian Pregnancy after IVF and Embryo Transfer – Case Report

Keisa¹,

Grabe²,

Rezeberga³

2016

Acta Chirurgica Latviensis

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SummaryOvarian pregnancy is one of the rarest types of ectopic pregnancy. The first case of it was reported by St. Maurice in 1689, and since then, few cases have been described in the literature. The incidence of ovarian pregnancy has recently increased due to the wider use of intrauterine devices and assisted reproductive techniques. The authors discuss the case of a 36-year-old primigravid woman who presented with abdominal pain, vomiting and amenorrhea. The patient has a two year history of primary infertility treated by in vitro fertilization. The ovarian pregnancy as the initial diagnosis was made during the operation and the final diagnosis was confirmed by the histopathological finding, which fulfilled Spiegelberg criteria.

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“…Post conservative management of ectopic pregnancy adhesions develops in the pelvic area and in turn, presence of pelvic adhesions increase the rate of ectopic pregnancy [9,10].…”

Section: Introductionmentioning

confidence: 99%