Clinical and Experimental Reproductive Medicine

The Korean Society for Reproductive Medicine (대한생식의학회)
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A Case Report of Heterotopic Pregnancy after IVF-ET

체외 수정후 발생한 병합임신 1예

  • Park, Chul-Min (Department of Obstetrics and Gynecology, School of medicine, Cheju National University) ;
  • Kim, Sung-Yop (Department of Obstetrics and Gynecology, School of medicine, Cheju National University) ;
  • Son, Young-Soo (Department of Obstetrics and Gynecology, School of medicine, Cheju National University)
  • 박철민 (제주대학교 의과대학 산부인과학교실) ;
  • 김성엽 (제주대학교 의과대학 산부인과학교실) ;
  • 손영수 (제주대학교 의과대학 산부인과학교실)
  • Published : 2005.12.30
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Abstract

Heterotopic pregnancy is named when an extrauterine (ectopic) pregnancy coexists with an intrauterine pregnancy simultaneously by many causes such as PID (pelvic inflammatory disease), endometriosis, IUD (intrauterine device), previous pelvic surgery and others. This is very rare in general population, with a range of occurrence estimated between 1:7963 and 1:30000. But recently the incidence has increased as the uses of ARTs (assisted reproductive technologies) including ovulation induction, IVF-ET (in-vitro fertilization and embryo transfer) and GIFT (gamete intrafallopian transfer) increase. Because this has high maternal morbidity, mortality and fetal loss, early diagnosis and proper management is very important. We report a case of heterotopic pregnancy following IVF-ET with a brief review.

Keywords

References

  1. Steadman HE. Combined intrauterine and extrauterine pregnancy. Obstet Gynecol 1953; 2: 277-80
  2. De Voe RW, Pratt JH. Simultaneous intrauterine and extrauterine pregnancy. Am J Obstet Gynecol 1948; 56: 1119-26 https://doi.org/10.1016/S0002-9378(48)90357-3
  3. Reece ED, Petrie RH, Sirmans HF, Finster M, Todd WD. Combined intrauterine and extrauterine gestation: A review. Am J Obstet Gynecol 1983; 146: 323-30 https://doi.org/10.1016/0002-9378(83)90755-X
  4. Molly W, Hynes J, Dreambrosis W, Harrison K, Keeping D, Hennessey J. Multiple-sited (heterotopic) pregnancy after in vitro fertilization and gamete intrafallopian transfer. Fertil Steril 1990; 53(6): 1068-71 https://doi.org/10.1016/S0015-0282(16)53587-0
  5. Yovich JL, MacColm SC, Turner SR, Matson PL. Heterotopic pregnancy from in vitro fertilization. J In Vitro Fert Embryo Transf 1985; 2(3): 143-50 https://doi.org/10.1007/BF01131501
  6. Varras M, Akivis C, Hadjopoulos G, Arnntoniou N. Heterotopic pregnancy in a natural cycle presenting with tubal rupture: A case of report and review if the literature. Eur J Obstet Gynecol Reprod Biol 2003; 106: 79-82 https://doi.org/10.1016/S0301-2115(02)00154-9
  7. 이대희, 김숙자, 유영, 황혜경, 최한종. Combined pregnancy의 1 예 . 대한산부회지 1971; 14: 39-40
  8. Vanderheyden JS, Van Dam PA. The rising incidence of heterotopic pregnancy: Two case reports. Eur J Obstet Gynecol Reprod Biol 1987; 24: 341-6 https://doi.org/10.1016/0028-2243(87)90160-2
  9. Gaudier FL, Brumfield CG, Delcambre CA, Steinkampf MP, Bernreuter W. Successful delivery of mature twins after a ruptured interstitial heterotopic pregnancy: A case report. J Reprod Med 1995; 40: 397-8
  10. Winer AE, Bergman WD, Fields C. Combined intraand extrauterine pregnancy. Am J Obstet Gynecol 1957; 74: 170-8 https://doi.org/10.1016/S0002-9378(16)37018-1
  11. Ross PD, Gunther RE. Combined pregnancy. Am J Obstet Gynecol 1970; 107: 1263-4 https://doi.org/10.1016/S0002-9378(15)30380-X
  12. Navot D, Margalioth EJ, Laufer N, Mor-Yosefs, Schenker JG. Asynchronous ovulation in human menopausal gonadotropin induction of ovulation for IVF. Fertil Steril 1984; 42: 806-7 https://doi.org/10.1016/S0015-0282(16)48213-0
  13. Tummon I, Whitmore N, Daniel S, Nicker J, Yuzpe A. Transferring more embryos increases the risk of heterotopic pregnancy. Fertil Steril 1994; 61: 1065-7 https://doi.org/10.1016/S0015-0282(16)56757-0
  14. Fisher AM, Goldberg BB. Usual case of heterotopic pregnancies in an in vitro fertilization-embryo transfer patient. J Ultrasound Med 1997; 16: 703-6 https://doi.org/10.7863/jum.1997.16.10.703
  15. Strandell, A, Thorburn J, Hamberger L. Risk factors for ectopic pregnancy in assisted reproduction. Fertil Steril 1999; 71(2): 282-6 https://doi.org/10.1016/S0015-0282(98)00441-5
  16. Gamberdella F, Marrs RP. Heterotopic pregnancy associated with ART. Am J Obstet Gynecol 1989; 160(6): 1520-2 https://doi.org/10.1016/0002-9378(89)90879-X
  17. Kouyoumdjian A, Kirkptrick J. Coexistence of intrauterine pregnancy with both an ectopic pregnancy and salpingitis in the right combined fallopian tube. A case report. J Reprod Med 1990; 35(8): 824-6
  18. Fernandez A, Lelaider C, Doumerc S, Fournet P, Olivennes F, Frydman R. Nonsurgical treatment of heterotopic pregnancy. A report of six cases. Fertil Steril 1993; 107: 1203
  19. Chin HY, Chen FP, Wang CJ, Shui LT, Liu YH, Soong YK. Heterotopic pregnancy after in vitro fertilization-embryo transfer. A case report. Int J Gynaecol Obstet 2004; 86: 411-6 https://doi.org/10.1016/j.ijgo.2004.05.011
  20. Duchinski T, Pisarek-Miedzinska D, Szczepanski M. Hemostatic variables in patients with intrauterine fetal death. Int J Gynaecol Obstet 1993; 42(1): 3-7 https://doi.org/10.1016/0020-7292(93)90437-2