#266 : Heterotopic Tubal Pregnancy After Frozen Embryo Transfer: A Case Report

Abstract

Background: Heterotopic pregnancy is a serious complication in vitro fertilization and embryo transfer (IVF-FET). The incidence of heterotopic pregnancy in assisted reproductive technique is 1-3%. The most common site of ectopic pregnancy both in spontaneous and ART is in tubal fallopian. This case can increase morbidity and mortality both in mother and intrauterine gestation, when delayed diagnosis happened. Case report: A 31-year-old woman presented to regular control after 14 days of frozen embryo transfer. The patient was transferred one good and one moderate blastocyst, and the [Formula: see text]-human chorionic gonadotropin ([Formula: see text]-hCG) level was 1960,6 mIU/mL and progesterone level were 54.04 ng/mL. The first transvaginal ultrasound found only one fifth weeks gestational sac. Two weeks after that, we found the same seventh weeks gestational sac. The patient then came on her 11[Formula: see text] week pregnant, and ultrasound revealed another gestational sac was implanted within the right fallopian tube and one more gestational sac was within intrauterine. Both babies were alive. Emergency Laparoscopy was performed, and it was found the gestational sac indeed was being implanted in the fallopian tube and some part of the placenta was implanted within the right ovary. We then performed the right salpingectomy. The other intrauterine pregnancy was then closely monitored, and until today, the mother and other baby is in good condition. Conclusion: Heterotropic pregnancy incidence increases greatly, especially in ART. Thus, as clinicians, closely monitoring ultrasound is needed in order to prevent late diagnosis of heterotropic pregnancy.