Abdominal heterotopic pregnancy post-IVF double embryo transfer

Area of Science:

• Reproductive Medicine
• Gynecologic Surgery
• Ectopic Pregnancy

Background:

• Abdominal ectopic pregnancies are rare, with the uterosacral ligament (USL) being an uncommon implantation site.
• Heterotopic pregnancies involve simultaneous intrauterine and ectopic gestations, often associated with assisted reproductive technologies.
• In vitro fertilization (IVF) with double embryo transfer increases the risk of heterotopic pregnancies.

Observation:

• A patient presented with acute abdominal pain six weeks post-double embryo transfer.
• Ultrasound suggested a live tubal ectopic pregnancy alongside a viable intrauterine pregnancy.
• Diagnostic laparoscopy identified an ectopic pregnancy implanted on the left USL.

Findings:

• The USL ectopic pregnancy was successfully resected.
• Histological examination confirmed the USL ectopic implantation.
• The patient recovered well, maintaining the viable intrauterine pregnancy.

Implications:

• This case is the first documented USL heterotopic pregnancy after IVF.
• Highlights the need to consider unusual ectopic pregnancy locations in IVF patients presenting with abdominal pain.
• Underscores the importance of thorough diagnostic evaluation for heterotopic pregnancies in at-risk populations.