Ovarian Ectopic Pregnancy After In Vitro Fertilization

Abstract

Figure 1. Ultrasound of the right ovarian ectopic pregnancy. Figure 2. Laparoscopic image showing the right ectopic pregnancy arising from the tip of the ovary. O ectopic pregnancy is even more rare after in vitro fertilization and embryo transfer (IVF-ET) than natural conception, with a reported incidence of 7:2745 IVF-ET pregnancies.1,2 A 34-year-old gravida 2, abortus 1 woman with infertility and patent fallopian tubes underwent IVF-ET. Two embryos, culture day 5, were transferred and placement within the uterus was confirmed with ultrasound. The patient’s β-hCG rose appropriately on post-ET days 9 and 11 (75 to 146 U/L). She remained asymptomatic throughout the pregnancy. Routine ultrasound performed at 7 weeks plus 2 days’ gestational age demonstrated an empty uterine cavity and a 1 cm embryo in the right adnexa with a fetal heart rate and visible yolk sac. At laparoscopy, a right ovarian ectopic pregnancy was seen arising from the tip of the ovary. The pregnancy was resected and the patient’s β-hCG level had decreased to 1 U/L by 6 weeks postoperative.