Abstract
Bilateral tubal ectopic pregnancy is a very rare form of ectopic pregnancy. The incidence is higher in women undergoing assisted reproductive techniques or ovulation induction. We report the case of bilateral tubal ectopic pregnancy. The patient was 30 years old and had a 3-year history of infertility; she was referred to the in-vitro fertilization (IVF) program because of tubal factor infertility. A pregnancy resulted from the transfer of two embryos during an artificial cycle. Despite the increase in β-hCG values during the follow-up, 22 days after the embryo transfer, the β-hCG levels were 2,408 U/L and the serum progesterone (P4) level was 10.53 ng/ml. After application with methotrexate, β-hCG levels did not decrease effectively. Moreover, the sonographic screening revealed a suspicious bilateral tubal focus for ectopic pregnancy. A mini-laparotomy was performed and a bilateral tubal pregnancy was found. In the case of unilateral tubal pregnancy after the transfer of two embryos, the situation of the other tube should be systematically checked and β-hCG levels should be monitored.
Highlights
Ectopic pregnancies (EPs) are known to occur with increased frequency after in-vitro fertilization (IVF) and related techniques
We report the case of bilateral tubal ectopic pregnancy
Recent studies have showed that pelvic inflammatory disease and subsequent tubal occlusion have been described as risk factors for EP following both natural and assisted conception.[8,9]
Summary
Ectopic pregnancies (EPs) are known to occur with increased frequency after in-vitro fertilization (IVF) and related techniques. Tubal infertility, previous pelvic surgery, and congenital uterine abnormalities have been defined as the leading factors contributing to the risk of EP in women with infertility.[3,4,5] The number and quality of transferred embryos, controlled ovarian stimulation (COS) regimens, laboratory conditions, and transfer techniques have been offered as possible contributors to the occurrence of EP after IVF-embryo transfer (ET).[6] Accurate management strategies for patients at risk of ectopic gestation after IVF-ET procedure has not been established This case report deals with this rare condition, bilateral tubal pregnancy, seen in association with IVF-ET. The levels of β-hCG had returned to below 50 U/l at the 3rdpostoperative week
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