Heterotopic pregnancy: it is really a rare event? The importance to exclude it not only after in vitro fertilization but also in case of spontaneous conception

Maruotti, Giuseppe Maria; Sarno, Lucio; Morlando, Maddalena; Sirico, Angelo; Martinelli, Pasquale; Russo, Tiziana

doi:10.1016/j.fertnstert.2010.05.001

Cited by 16 publications

(7 citation statements)

References 4 publications

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“…Heterotopic pregnancy (HP) is a rare and fatal condition. Its incidence is known to be one in 8,000 to 30,000 in spontaneous conceptions increasing to a rate of 0.2% to 1% in gestations after assisted reproductive technologies [ 1 2 3 ]. However, the detection of HP could be neglected in an infertile woman who underwent single embryo transfer (SET) because this procedure significantly reduces the incidence of twin pregnancies and where twin pregnancies do occur after SET most are monozygotic [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Heterotopic pregnancy after a single embryo transfer

et al. 2016

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Heterotopic pregnancy is a rare and life-threatening condition which is defined as coexistent intrauterine and ectopic gestation. The risk of ectopic and heterotopic pregnancy is increasing due to the increased risk of multiple pregnancies with the aid of assisted reproductive technologies. However, it hardly happens in the setting of single embryo transfer, since single embryo transfer significantly reduces the incidence of multiple pregnancies. Surprisingly, we experienced a case of heterotopic pregnancy after a single embryo transfer caused by coincidental natural pregnancy during assisted reproductive technologies. An infertile woman who underwent, during her natural cycle, transfer of a single embryo that had been cryopreserved for 3 years was found to be heterotopically pregnant. After an early and successful management with laparoscopic right salpingectomy, she finally reached at full-term vaginal delivery.

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Section: Introductionmentioning

confidence: 99%

Heterotopic pregnancy after a single embryo transfer

et al. 2016

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“…In our study, 3 patients received surgery due to EP rupture in expectant group; thus, surgical may as a priority for the management of HP. Studies have demonstrated that laparoscopy is effective and safe during the rst trimester of pregnancy [22], which has the advantages of less postoperative pain, better operative eld exposure, and minimal manipulation [23]. In the present study, 29 (72.5%) patients underwent surgery without any congenital abnormalities or deleterious anesthetic complications.…”

Section: Discussionmentioning

confidence: 50%

Study On Diagnosis And Management Strategies On Heterotopic Pregnancy

Zhang

Chen

Lin

et al. 2021

Preprint

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Objective The aims of this study were to analysis the clinical characteristics of women with heterotopic pregnancy (HP) following embryo transfer (ET) and explore the early predictors for pregnancy outcomes.Methods This retrospective study reviewed patients with HP following assisted reproductive technology (ART) in our institution between January 2013 and December 2020. The relationships between pregnancy outcomes and general features, ultrasonic characteristics and different treatment modality were analyzed by logistic regression analysis.Results Fourty patients were identified, including 27 with tubal HP, 7 interstitial HP and 6 cornual HP. The most frequent manifestations before diagnosis was vaginal bleeding (30.0%), while 7 patients (17.5%) had no symptoms before diagnosis. The mean gestational age at symptom onset was 44.8 ± 8.6 days (range 27–68). Gestational age at diagnosis was 49.4 ± 7.6 days (range 29–68). Among these cases, twenty-nine patients of HP were accurately diagnosed by transvaginal ultrasonography (TVS). Hence, the sensitivity of TVS for detecting HP was 72.5% (29/40). Eleven patients received expectant management, while 29 patients underwent laparotomy (13/29) or laparoscopy (16/29) surgery. Gestational age at surgery day was 51.0±8.6 days (range 33–67). Live births occurred for 18 patients in the surgery group, 3 of whom delivered preterm. Additionally, the miscarriage rate was lower for patients with IUP cardiac activity (16.7% vs. 90.0%) than patients without IUP cardiac activity at HP diagnosis (P < 0.001). Further by logistic regression analysis, an IUP with cardiac activity at HP diagnosis was identified as an independent factors of pregnancy outcome (P<0.001).Conclusions Symptoms combined with routine TVS scans could reduce misdiagnosis and facilitate the diagnosis of HP. An IUP with cardiac activity at HP diagnosis as predictors for a favorable prognosis of HP. Prompt surgical intervention after diagnosis may minimize the incidence of abortion of IUP.

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“…7.11 ) [ 55 ]. The incidence may be higher in gestations after assisted fertility [ 56 ] and has been estimated as high as 1 in 100 in this population [ 40 ]. Thus, in patients who have undergone ART, despite the presence of an IUP, a thorough interrogation of the adnexae is recommended, to rule out a heterotopic pregnancy.…”

Section: Heterotopic Pregnancymentioning

confidence: 99%