Heterotopic Triplet Pregnancy After Assisted Reproductive Techniques: A Systematic Review.
Ioannis Korkontzelos1, Petros Papalexis2, Vasiliki E Georgakopoulou3
1Department of Obstetrics and Gynecology, Ioannina State General Hospital "G. Chatzikosta", Ioannina, GRC.
Cureus
|January 21, 2025
Summary
Heterotopic triplet pregnancy, a rare condition involving simultaneous intrauterine and ectopic embryos, is increasingly linked to assisted reproductive techniques. Early diagnosis and management are crucial for optimal maternal and fetal outcomes.
Area of Science:
- Reproductive Medicine
- Gynecology
- Obstetrics
Background:
- Heterotopic pregnancy, the simultaneous occurrence of intrauterine and extrauterine pregnancies, is rare.
- Heterotopic triplet pregnancy, involving three embryos with at least one ectopic, is exceedingly rare.
- Assisted reproductive techniques (ART) have led to an increase in non-spontaneous heterotopic triplet pregnancies.
Purpose of the Study:
- To provide an analytic overview of heterotopic triplet pregnancies following ovulation induction and ART.
- To review cases reported in the English literature up to December 2023.
- To identify clinical messages for managing this rare condition.
Main Methods:
- Literature review of heterotopic triplet pregnancies after ART.
- Searches conducted on PubMed, Scopus, and Google Scholar.
- Analysis of 57 reported cases, recording various clinical and obstetric parameters.
Main Results:
- The commonest site for ectopic pregnancy in these cases is the salpinx.
- Misdiagnosis or delayed diagnosis remains a challenge, despite the life-threatening potential.
- No consensus exists on treatment strategies, with data primarily from case reports.
Conclusions:
- ART increases the risk of heterotopic triplet pregnancies.
- Transferring a maximum of two embryos per cycle is recommended to minimize multiple gestations.
- Vigilance, early diagnosis, and appropriate interventions are essential for high-risk pregnancies post-IVF.
