Ovarian pregnancy after IVF-ET in a patient with absent tube

Successful laparoscopic management of a rare complication after embryo transfer: ovarian pregnancy. A case report and up-to-date literature review

Ovarian pregnancy (OP) after embryo transfer is very rare. Due to the rarity and the asymptomatic nature, there are still difficulties in diagnosis and treatment. The traditional operative treatment for OP has been oophorectomy. However, the desire to maintain reproductive capability and improvements in laparoscopy have more recently led to conservative laparoscopic techniques. This rare complication could be diagnosed early and managed by a conservative laparoscopic approach. Here we present a survey of the literature and a case of successful laparoscopic management of ovarian pregnancy after intracytoplasmic sperm injection and embryo transfer. The current case is the first case in the literature in which ovarian pregnancy occurred after a single embryo transfer. We also summarize the literature about management of ovarian pregnancy after embryo transfer.

Ovarian pregnancy resulting from cornual fistulae in a woman who had undergone bilateral salpingectomy

OBJECTIVE

To report a case of ovarian pregnancy following in vitro fertilization-embryo transfer (IVF-ET) treatment for which the cornual fistulae was the most probable explanation of the cause.

DESIGN

Case report.

SETTING

University department and assisted reproduction unit.

PATIENT(S)

A 29-year-old woman with primary infertility.

INTERVENTION(S)

Hydrosalpinx of the bilateral fallopian tubes has been noted in patients who have decreased pregnancy rates in the IVF-ET treatment cycles. Salpingectomy before IVF cycles has been suggested to increase the pregnancy rate. We report a patient who presented with bilateral hydrosalpinx for whom bilateral salpingectomy was performed before IVF treatment.

MAIN OUTCOME MEASURE(S)

Clinical pregnancy.

RESULT(S)

The treatment cycle resulted in a primary ovarian pregnancy and required laparoscopic operation. A cornual fistulae was found that have might led to ectopic implantation of the embryos.

CONCLUSION(S)

Ovarian pregnancy may be an unexpected complication of those receiving bilateral salpingectomy before IVF treatment. The presence of cornual fistulae after salpingectomy was probably the cause of the ectopic pregnancy.

Tubal pregnancy following tubal embryo transfer into the contralateral fallopian tube

Ectopic and heterotopic pregnancy may occur with increased frequency following assisted reproductive technology (ART) procedures. In addition, there may be unusual sites of implantation, which may cause atypical and confusing clinical manifestations. We present a case of tubal pregnancy after tubal embryo transfer (TET) to the contralateral fallopian tube. Four embryos were transferred to the left fallopian tube by laparoscopy, but the patient developed a right tubal pregnancy, possibly as a result of intrauterine or intra-abdominal migration of the embryo. ART patients must be followed closely soon after the procedure, and there should be a high index of suspicion for an unusual implantation site.