Heterotopic Pregnancy After Intracytoplasmic Sperm Injection With Viable Embryos: A Case Report and Literature Review

Heterotopic pregnancy is defined as the simultaneous presence of gestation in two different sites, typically comprising an intrauterine pregnancy and an ectopic pregnancy. Due to the widespread use of assisted reproductive technologies (ARTs), the incidence of heterotopic pregnancies has increased significantly. A 36-year-old Caucasian woman, gravida 1, para 0, Rhesus positive, was referred to our hospital with a suspected ectopic pregnancy following her third in vitro fertilization with intracytoplasmic sperm injection cycle. The patient reported no vaginal bleeding or abdominal pain at the time of admission. Her medical history included dysmenorrhea, dyspareunia, and prior hysteroscopic removal of an endometrial polyp. She had no other significant medical, surgical, or family history. Transvaginal ultrasound confirmed the diagnosis of a heterotopic pregnancy. The patient underwent surgical management to address the ectopic component. The incidence of heterotopic pregnancy has risen in recent years due to the increased use of ARTs. In cases of tubal ectopic pregnancy, surgical intervention should be carefully considered, even when the risk to the coexisting intrauterine pregnancy cannot be entirely excluded.