Ovarian pregnancy and the intrauterine contraceptive device

Abstract

A case report of an IUD user with a primary ovarian pregnancy is presented. Although it appears that a local of the endometrium to the IUD is inimical to either the sperm or the fertilized ovum thereby inhibiting an intrauterine gestation the response does not spread laterally so that an ovarian pregnancy is not prevented by the foreign body. A 28-year-old woman para 3 was inserted with a Dalkon Shield in May 1972. She was asymptomatic until October 3 1972 when her period was 1 week late and she developed abdominal cramps and began to stain. 2 days later the womans physician removed the IUD because he felt a tender thickening in the left fornix and suspected infection. The woman was treated but the thickening became more pronounced. After a pelvic examination an exploratory operation was performed with a provisional diagnosis of unruptured ectopic pregnancy. At operation it was discovered that the left ovary was replaced by a rather firm mass about 10 cm in diameter containing several thin walled cysts. A left oophorectomy was carried out. Attached to 1 side of the cavity was a small friable gray-white tissue .5 cm in its greatest diameter which proved to be a degenerated embryo. It is noted that one should be mindful of the possibility of an ectopic pregnancy in IUD users when a unilateral tender thickening or mass appears for the first time and fails to respond to antibiotics and the removal of the foreign body.