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Baghdadi T, Salle B, Bordes A, Lamblin G. Simultaneous bilateral tubal ectopic pregnancy after intracytoplasmic sperm injection and embryo transfer, in a patient with Stage 3 endometriosis. Gynecol Minim Invasive Ther 2017; 6:199-201. [PMID: 30254915 PMCID: PMC6135200 DOI: 10.1016/j.gmit.2017.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Revised: 02/27/2017] [Accepted: 03/07/2017] [Indexed: 11/26/2022] Open
Abstract
Introduction The incidence of extrauterine pregnancy increases to 2-12% following in vitro fertilization -embryo transfer. Several pathogenic theories have been suggested, including abnormal hormonal secretion or exogenous hormones administered in assisted reproductive technology (ART). Case report A 32-year-oId nulliparous woman with primary infertility and Stage 3 endometriosis was treated by ART with intracytoplasmic sperm injection and embryo transfer. The patient showed simultaneous bilateral extrauterine pregnancy, managed by laparoscopic salpingectomy. Discussion The various possible pathophysiological mechanisms are described, with a review of the literature on simultaneous bilateral extrauterine pregnancy following ART. In pregnancies following ART, ectopic pregnancy should always be screened for by serum β-human chorionic gonadotropin monitoring and transvaginal ultrasound until the implantation site can be confirmed as the incidence is higher than in spontaneous pregnancy. Even if serum β-human chorionic gonadotropin concentration increases normally, possible bilateral ectopic pregnancy should always be investigated if no intrauterine gestational sac can be seen.
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Affiliation(s)
- Tariq Baghdadi
- Department of Obstetrics and Gynecology, Femme-Mère-Enfant University Hospital, Bron, France.,Department of Reproductive Medicine, Femme-Mère-Enfant University Hospital, Bron, France
| | - Bruno Salle
- Department of Reproductive Medicine, Femme-Mère-Enfant University Hospital, Bron, France
| | - Agnès Bordes
- Department of Obstetrics and Gynecology, Femme-Mère-Enfant University Hospital, Bron, France.,Department of Reproductive Medicine, Femme-Mère-Enfant University Hospital, Bron, France
| | - Gery Lamblin
- Department of Obstetrics and Gynecology, Femme-Mère-Enfant University Hospital, Bron, France
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2
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Bilateral ectopic tubal pregnancy, following in vitro fertilisation (IVF). Folia Histochem Cytobiol 2016; 47:S147-8. [PMID: 20067887 DOI: 10.2478/v10042-009-0093-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
This is a case report of a 33 year-old-woman who underwent in vitro fertilization, because of primary infertility caused by fallopian tube factor. The patient underwent three trials of frozen embryo transfers (ET-CRYO). On the 26th day after the third probe of ET-CRYO she suffered from pelvic pain and vaginal bleeding. Transvaginal ultrasonographic scan revealed bilateral tubal ectopic pregnancy without fluid in the Douglas pouch and no gestational sac in the uterus. Laparoscopic bilateral salpingectomy was performed on the next day after admission. The postoperative course was uneventful.
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3
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Bayyarapu VB, Bettaiah R, Saraogi R. Incidental Laparoscopic Diagnosis of a Concurrent Contralateral Ectopic Pregnancy in a Donor Egg Recipient with Left Tubal Gestation. J Gynecol Surg 2014. [DOI: 10.1089/gyn.2013.0090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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4
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Plotti F, Nelaj E, Sansone M, Boni T, Panici PB. Bilateral Tubal Pregnancy with Live Embryos After Intracytoplasmatic Sperm Injection. J Gynecol Surg 2009. [DOI: 10.1089/gyn.2009.0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Francesco Plotti
- Department of Obstetrics and Gynecology, “La Sapienza” University of Rome, Rome, Italy
| | - Ermal Nelaj
- Department of Obstetrics and Gynecology, “La Sapienza” University of Rome, Rome, Italy
| | - Milena Sansone
- Department of Obstetrics and Gynecology, “La Sapienza” University of Rome, Rome, Italy
| | - Terenzio Boni
- Department of Obstetrics and Gynecology, “La Sapienza” University of Rome, Rome, Italy
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5
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De Los Ríos JF, Castañeda JD, Miryam A. Bilateral ectopic pregnancy. J Minim Invasive Gynecol 2007; 14:419-27. [PMID: 17630158 DOI: 10.1016/j.jmig.2007.01.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2006] [Revised: 01/24/2007] [Accepted: 01/28/2007] [Indexed: 10/23/2022]
Abstract
Bilateral simultaneous ectopic pregnancy is a very rare clinical condition. Two different subsets of patients can be distinguished: women presenting with the disease as a result of spontaneous conception and those with the condition after undergoing assisted reproduction procedures. This article reviews and analyzes 42 cases of bilateral ectopic pregnancies reported in the last 10 years, proposes a new classification of the disease, and presents some data that should be useful for the clinician who confronts this difficult entity.
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6
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Campo S, Campo V, Gambadauro P. Bilateral tubal pregnancy following in vitro fertilization and embryo transfer. Eur J Obstet Gynecol Reprod Biol 2003; 110:237-9. [PMID: 12969592 DOI: 10.1016/s0301-2115(03)00103-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Sebastiano Campo
- Department of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, Rome 00168, Italy.
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7
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Tay JI, Whitehead A, Joyce AD, Rutherford AJ. Twin pregnancy following IVF treatment using frozen-thawed retrograde ejaculated sperm. J Assist Reprod Genet 1996; 13:731-2. [PMID: 8947823 DOI: 10.1007/bf02066428] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Affiliation(s)
- J I Tay
- Assisted Conception Unit, General Infirmary, U.K
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8
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Aanesen A, Flam F. Bilateral tubal pregnancy following in vitro fertilization and transfer of two embryos. Eur J Obstet Gynecol Reprod Biol 1996; 64:235-6. [PMID: 8820011 DOI: 10.1016/0301-2115(95)02328-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
A case of simultaneous bilateral tubal pregnancy after IVF-ET treatment is presented. This condition occurred despite the fact that only two embryos were transferred. Due to misinterpretation of repeated sonographic images, the diagnosis was delayed, and laparatomy with bilateral salpingectomy was not performed until 57 days had passed from the day of ET. Although there is a substantial risk of ectopic pregnancy following IVF-ET, this risk should be reduced as the number of embryos transferred per cycle decreases. This is, to the best of our knowledge, the first report of bilateral tubal pregnancies following the transfer of only two embryos.
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Affiliation(s)
- A Aanesen
- Division of Woman and Child Health, Karolinska Hospital, Stockholm, Sweden
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9
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Kauppi-Sahla M, Rintala H, Mäkinen J. Bilateral tubal pregnancy: a case report and review of the literature. Eur J Obstet Gynecol Reprod Biol 1991; 40:145-7. [PMID: 1830019 DOI: 10.1016/0028-2243(91)90106-u] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
We describe a patient whose secondary infertility was treated with clomifen. She developed a bilateral tubal pregnancy which was confirmed histologically. A short review of the pertinent literature is also presented.
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Affiliation(s)
- M Kauppi-Sahla
- Turku University Central Hospital, Department of Gynecology and Obstetrics, Finland
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Bearman DM, Vieta PA, Snipes RD, Gobien RP, Garcia JE, Rosenwaks Z. Heterotopic pregnancy after in vitro fertilization and embryo transfer. Fertil Steril 1986; 45:719-21. [PMID: 3699174 DOI: 10.1016/s0015-0282(16)49348-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
We have presented a second case of heterotopic pregnancy after IVF-ET. The most likely cause is direct extrusion of embryos through the tubal ostia by the hydrostatic pressure associated with ET. The diagnosis of ectopic pregnancy must be suspected clinically and not ruled out on the sonographic demonstration of an intrauterine pregnancy. Early diagnosis is essential for the prevention of significant maternal morbidity and mortality after IVF-ET.
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Frydman R, Belaisch-Allart J, Fries N, Hazout A, Glissant A, Testart J. An obstetric assessment of the first 100 births from the in vitro fertilization program at Clamart, France. Am J Obstet Gynecol 1986; 154:550-5. [PMID: 3953702 DOI: 10.1016/0002-9378(86)90600-9] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
From April, 1981, to July, 1984, 142 pregnancies have been attained after in vitro fertilization and embryo transfer. They are divided into 22 biochemical pregnancies (human chorionic gonadotropin greater than or equal to 20 mU/ml but remaining below 1000 mU/ml), 27 spontaneous abortions, three ectopic pregnancies, and 90 ongoing pregnancies, of which 11 were twin pregnancies. The 90 women in whom the pregnancies progressed were compared with the 52 women having nonprogressive pregnancies. The two populations did not differ either in age, in the indication for in vitro fertilization and embryo transfer, or in the quality of ovulation or results of semen analysis. The 90 ongoing pregnancies were compared with those pregnancies occurring in the same obstetrics department during this period. We found that the in vitro fertilization group had a higher proportion of arterial hypertension (16.5% versus 8.5%, p less than 0.05), breech presentations (13.9% versus 4.3%, p less than 0.001), and caesarean sections (46.8% versus 15.5%, p less than 0.001) but the sex ratio did not differ.
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12
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Martinez F, Trounson A. An analysis of factors associated with ectopic pregnancy in a human in vitro fertilization program. Fertil Steril 1986; 45:79-87. [PMID: 2417891 DOI: 10.1016/s0015-0282(16)49101-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Between 1980 and 1985, in Monash University in vitro fertilization (IVF) program, ectopic pregnancy occurred in 10 of 256 IVF pregnancies. The incidence of ectopic pregnancy between 1983 and 1984 was 4% of the total pregnancies, or 4.2% of pregnancies excluding biochemical pregnancies. The incidence of ectopic pregnancy was distributed equally across the infertility classifications (tubal, idiopathic, male factor, and mixed). There appeared to be no relationship between superovulatory methods, endocrine changes before egg recovery, laparoscopic procedures, embryo transfer procedures, and number of embryos transferred. Nine of the ten patients were classified as having either tubal factor infertility before IVF or chronic tubal inflammation, which probably existed at the time of embryo replacement. No ectopic pregnancies were recorded in the 33 pregnancies obtained with superovulation with the use of clomiphene citrate alone. We were unable to identify a major predisposing factor for ectopic pregnancy in IVF.
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Trotnow S, Kniewald T, Hünlich T, Siebzehnrübl E, Kreuzer E, Habermann PG. Experiences with the first 100 consecutive pregnancies achieved after in vitro fertilization and embryo transfer at the University Women's Hospital in Erlangen. ARCHIVES OF GYNECOLOGY 1985; 237:57-66. [PMID: 3936422 DOI: 10.1007/bf02199709] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
As of March 31, 1985, 100 clinical pregnancies have been achieved since the program for extracorporeal fertilization was started in Erlangen. 531 (71%) of 768 follicular punctures resulted in an embryo transfer. The overall pregnancy rate is 13% with regard to the total number of laparoscopies and 19% with regard to the number of embryo transfer. The most effective stimulation proved to be the pure hMG regimen. Employing this protocol, we have achieved a clinical pregnancy rate after IVF and ET of 32% during the last 6 months. Oocyte recovery related to the number of patients is 97%, with laparoscopy being superior to ultrasonically guided puncture. The success rate is appreciably affected by both the number of transferred embryos and the atraumatic transfer technique. We question the rationale of supporting the luteal phase.
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Darstellung der Methodik. Arch Gynecol Obstet 1985. [DOI: 10.1007/bf02429922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Hünlich T, Trotnow S, Mulz D, Kniewald T. Hormonal and ultrasonic characteristics of 23 clomiphene citrate stimulated cycles resulting in pregnancies after in vitro fertilization and embryo transfer. ARCHIVES OF GYNECOLOGY 1984; 236:19-33. [PMID: 6391394 DOI: 10.1007/bf02114865] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
In vitro fertilization (IVF) and embryo transfer (ET) were successful in 24 clomiphene citrate stimulated cycles in 22 patients. Ovarian follicular growth was monitored by ultrasound (US) and serum estradiol (E2) concentrations in order to determine the most favorable time for the induction of ovulation by administration of human chorionic gonadotropin (hCG). The day of the hCG injection was considered day 0. After an almost linear growth the mean diameter of the dominant follicle reached 19.3 +/- 2 mm on day 0. Serum E2 concentrations also increased in almost linear fashion up to a maximum of 1,037 +/- 322 pg/ml on day +1. On day 0 the mean serum E2 concentration was 862 +/- 279 pg/ml. A mean serum E2 concentration per dominant and codominant follicle of 328 +/- 100 pg/ml was found on day 0. There was no linear correlation between the follicular diameters and the serum E2-values on the same day. The time of ovum recovery was often different to the time at which ovulation would have been expected in a normal cycle.
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