scholarly journals Rare heterotopic pregnancy after frozen embryo transfer: a case report and literature review

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Xianping Wang ◽  
Ding Ma ◽  
Yangang Zhang ◽  
Yanhua Chen ◽  
Yuxia Zhang ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Left Kidney ◽  
Frozen Embryo Transfer ◽  
Heterotopic Pregnancy ◽  
Psoas Major Muscle ◽  
History Of ◽  
Gestational Sac ◽  
Β Hcg ◽  
Ectopic Pregnancies ◽  
Psoas Major

Abstract Background Heterotopic pregnancy occurred after frozen embryo transfer with two D3 embryos, and the case had a history of bilateral salpingectomy due to salpingocyesis. An ectopic heterotopic pregnancy was implanted in the left psoas major muscle, which has not been previously reported. Case presentation A 33-year-old woman presented with left back pain after curettage due to foetal arrest in the uterus without vaginal bleeding and spotting, and painkillers relieved the pain initially. When the painkillers ceased to work, the patient returned to the hospital. The β-human chorionic gonadotropin (β-hCG) level remained increased compared with the time of curettage, and a diagnosis of retroperitoneal abdominal pregnancy was suggested by ultrasonography and computerized tomography (CT) with the gestational sac implanted in the left psoas major muscle at the left hilum level. Laparotomy was performed to remove the ectopic pregnancy. During the operation, we carefully separated the adipose tissue between the space of the left kidney door and left psoas major muscle, peeled away the gestational sac that was approximately 50 mm × 40 mm with a 25-mm-long foetal bud, and gave a local injection of 10 mg of methotrexate in the psoas major muscle. Fifty days later, β-hCG decreased to normal levels. Conclusion It is necessary to pay more attention to the main complaints to exclude rare types of ectopic pregnancies of the pelvis and abdomen after embryo transfer.

scholarly journals Cervical Twin Heterotopic Pregnancy: Overview of Ectopic Pregnancies and Scanning Detection Algorithm

Medicina ◽  
2021 ◽  
Vol 57 (9) ◽  
pp. 969
Author(s):  
Antonios Koutras ◽  
Zacharias Fasoulakis ◽  
Michail Diakosavvas ◽  
Athanasios Syllaios ◽  
Athanasios Pagkalos ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Uterine Cavity ◽  
Medical Abortion ◽  
First Trimester ◽  
Detection Algorithm ◽  
Heterotopic Pregnancy ◽  
Cervical Canal ◽  
Mortality And Morbidity ◽  
Gestational Sac ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy is the leading cause of gestation-related deaths during the first trimester. Cervical twin heterotopic pregnancies, when ectopic, constitute a small and rare part of gynecological surgery. Case Presentation: A 30-year-old pregnant woman (gravida 3, para 2) presented with mild pain in the lower abdomen and traces of bleeding per vaginum for three days. Transvaginal ultrasonography revealed a balloon-shaped cervical canal with a visible gestational sac measuring 3.5 × 3.9 cm. A second gestational sac was seen in the uterine cavity. The measurements of the gestational sacs corresponded to 7 + 4 weeks’ pregnancy. A decision for medical abortion with mifepristone and misoprostol was made. However, due to an incomplete abortion and continuous bleeding, a curettage was performed. Conclusions: Spontaneous heterotopic pregnancy with the ectopic pregnancy located in the cervix is an extremely rare clinical condition requiring urgent treatment in order to reduce maternal mortality and morbidity and preserve fertility.

scholarly journals A Rare Case of Bilateral Tubal Ectopic Pregnancy Following Intracytoplasmic Sperm Injection-Embryo Transfer (ICSI-ET)

2020 ◽  
Vol 42 (03) ◽  
pp. 165-168
Author(s):  
Ferruh Acet ◽  
Ege Nazan Tavmergen Goker ◽  
Ismet Hortu ◽  
Gulnaz Sahin ◽  
Erol Tavmergen
Keyword(s):  
Ectopic Pregnancy ◽  
Embryo Transfer ◽  
Tubal Pregnancy ◽  
Serum Progesterone ◽  
Tubal Ectopic Pregnancy ◽  
Vitro Fertilization ◽  
Reproductive Techniques ◽  
History Of ◽  
Β Hcg

AbstractBilateral tubal ectopic pregnancy is a very rare form of ectopic pregnancy. The incidence is higher in women undergoing assisted reproductive techniques or ovulation induction. We report the case of bilateral tubal ectopic pregnancy. The patient was 30 years old and had a 3-year history of infertility; she was referred to the in-vitro fertilization (IVF) program because of tubal factor infertility. A pregnancy resulted from the transfer of two embryos during an artificial cycle. Despite the increase in β-hCG values during the follow-up, 22 days after the embryo transfer, the β-hCG levels were 2,408 U/L and the serum progesterone (P4) level was 10.53 ng/ml. After application with methotrexate, β-hCG levels did not decrease effectively. Moreover, the sonographic screening revealed a suspicious bilateral tubal focus for ectopic pregnancy. A mini-laparotomy was performed and a bilateral tubal pregnancy was found. In the case of unilateral tubal pregnancy after the transfer of two embryos, the situation of the other tube should be systematically checked and β-hCG levels should be monitored.

scholarly journals Hormone replacement therapy may increase the risk of early miscarriage during frozen embryo transfer cycles in patients with a history of cesarean section: a retrospective cohort study

2021 ◽  
Author(s):  
Run-xin Gan ◽  
Yuan Li ◽  
Juan Song ◽  
Quan Wen ◽  
Guang-xiu Lu ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Retrospective Cohort ◽  
Outcome Measure ◽  
Hormone Replacement ◽  
Frozen Embryo Transfer ◽  
Miscarriage Rate ◽  
Endometrial Preparation ◽  
History Of ◽  
Early Miscarriage ◽  
Singleton Pregnancies

Objective: To investigate the efficacies of three cycle regimens in women receiving FET with a history of CS: natural cycle (NC) treatment, hormone replacement therapy (HRT) and treatment with gonadotropin-releasing hormone agonist (GnRH-a) + HRT). Design: Retrospective cohort study. Setting: University-affiliated center. Population: Patients (N = 6,159) with a history of CS who fulfilled the inclusion criteria were enrolled in the study from January 2014 to December 2019. Methods: Reproductive outcomes of patients in the NC (n = 4,306) versus HRT (n = 1,007) versus GnRH-a + HRT groups (n = 846) were compared. Main Outcome Measure: The main outcome measure was the live birth rate per embryo transfer (ET). Results: The unadjusted odds of the miscarriage rate of singleton pregnancies were also significantly higher in the HRT-group compared with the NC-group (25.5% versus 20.4%, respectively). After adjusting for possible confounding factors, the early miscarriage rate and the miscarriage rate of singleton pregnancies remained significantly higher in the HRT-group than the NC-group. The clinical pregnancy rates in the NC-, HRT- and GnRH-a + HRT-groups of women with a history of CS was 48.8%, 48% and 47.1%, respectively, and the live birth rates were 37%, 34.1% and 35.7%, respectively. Conclusion(s): In women undergoing FET with a history of CS, HRT for endometrial preparation was associated with a higher early miscarriage rate, albeit after statistical adjustment for confounding factors. Funding: The National Science Foundation of China (81501328). Key Words: Caesarean section, endometrial preparation, frozen embryo transfer, miscarriage

scholarly journals Risk factors and pregnancy outcomes of heterotopic pregnancy secondary to in vitro fertilization-embryo transfer: A case series study

2020 ◽  
Author(s):  
Shaomi Zhu ◽  
Qinxiu Zhang ◽  
Linjiang Song
Keyword(s):  
Embryo Transfer ◽  
Pregnancy Outcomes ◽  
Case Series ◽  
Tubal Infertility ◽  
Vitro Fertilization ◽  
Operative Duration ◽  
History Of ◽  
Ectopic Pregnancies ◽  
Ivf Et

Abstract Background: The early diagnosis and treatment of heterotopic pregnancy (HP) remain one of the biggest challenges in the field of gynecology. A coexisting intrauterine gestation makes the ectopic pregnancy in HP more difficult to diagnose. This case series analysis is designed to explore factors affecting the incidence of HP secondary to in vitro fertilization-embryo transfer (IVF-ET) and that affecting pregnancy outcomes after surgical treatment of HP.Methods: From the IVF registry system, the clinical data of 29 patients with HP and 92 with an intrauterine-only pregnancy (IUP) following embryo transfer from January 2009 to December 2017 were retrospectively analyzed.Results HP had a higher proportion of previous ectopic pregnancies, multiple abortion history ( ≧ 2 times) and tubal indication for IVF than IUP. In patients with HP, 31.03% had spontaneous abortion, 25.00% had preterm delivery and 58.62% resulted in a live birth. According to the results from logistic regression, history of multiple abortions (odds ratio (OR) 3.031, 95% confidence intervals (CI) 1.087-8.453; P=0.034), tubal infertility (OR 3.844, 95% CI 1.268-11.656; P=0.017), previous ectopic pregnancies (OR 2.303, 95% CI 0.625-8.490; P=0.021) and multiple embryo transfer ( OR 0.300, 95% CI 0.092-0.983; P=0.037) resulted in an elevated proportion of HP in IVF cycles. Incidence of HP was comparable between patients transferred with blastocyst and cleavage embryos. Shorter operative duration, smaller size of the ectopic mass and location in the ampulla of the fallopian tube were associated with higher chance of survival in the coexistent intrauterine pregnancy after surgical treatment with HP.Conclusions:The early diagnosis of HP remains a challenge. Previous history of ectopic pregnancy, multiple abortions, tubal infertility and multiple embryo transfer may be considered as meaningful risk factors of subsequent HP following IVF-ET. In patients with HP treated by surgery, shorter operative duration, smaller size of the ectopic mass and location in the ampulla of the fallopian tube means better reproductive prognosis.

scholarly journals Do patients with a history of chronic endometritis benefit from corticosteroids and antibiotics before frozen embryo transfer?

2019 ◽  
Vol 112 (3) ◽  
pp. e165
Author(s):  
Nicole D. Yoder ◽  
David H. McCulloh ◽  
James A. Grifo ◽  
Frederick L. Licciardi
Keyword(s):  
Embryo Transfer ◽  
Frozen Embryo Transfer ◽  
Chronic Endometritis ◽  
History Of

scholarly journals The effect of platelet-rich plasma on the achievement of pregnancy during frozen embryo transfer in women with a history of failed implantation

Heliyon ◽  
2020 ◽  
Vol 6 (3) ◽  
pp. e03577
Author(s):  
Azra Allahveisi ◽  
Fariba Seyedoshohadaei ◽  
Masomeh Rezaei ◽  
Narges Bazrafshan ◽  
Kaveh Rahimi
Keyword(s):  
Embryo Transfer ◽  
Platelet Rich Plasma ◽  
Frozen Embryo Transfer ◽  
History Of

scholarly journals Pitfalls in Diagnosing Heterotopic Pregnancy in Sub-Saharan Africa: A Case Report at the Yaounde University Teaching Hospital (Cameroon)

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Andre Ngandji Dipanda ◽  
Jovanny Tsuala Fouogue ◽  
Valere Koh Mve ◽  
Bruno Kenfack ◽  
Jean Dupont Ngowa Kemfang
Keyword(s):  
Teaching Hospital ◽  
Clinical Signs ◽  
Sub Saharan Africa ◽  
University Teaching ◽  
Heterotopic Pregnancy ◽  
Resource Poor ◽  
Wrong Diagnosis ◽  
Gestational Sac ◽  
Sub Saharan ◽  
Ectopic Pregnancies

Heterotopic pregnancy (HP) is a dizygotic twin pregnancy in which one gestational sac is intrauterine and the other is extrauterine. The prevalence of HP is unknown in Cameroon where the diagnosis is difficult and usually fortuitous like in other resource-poor settings. We herein depict pitfalls and delays in the diagnosis and management of a ruptured heterotopic pregnancy at the Yaounde University Teaching Hospital. After a wrong diagnosis and inadequate treatment, our patient presented at our emergency unit with severe pelvic pain and clinical signs of hemoperitoneum with shock. She underwent a total left salpingectomy through laparotomy. She had a complete spontaneous abortion five days after the surgery. Given that sonography is not routinely available in emergency departments in resource-poor settings, it may be relevant for practitioners to always bear HP in mind when facing ruptured ectopic pregnancies.

scholarly journals Managing Ectopic Pregnancies by Targeting Chorionic Villi with a Transvaginal Injection of Ethanol into the Lacunar Space

Biomedicines ◽  
2020 ◽  
Vol 8 (7) ◽  
pp. 202
Author(s):  
Hisao Osada ◽  
Shokichi Teramoto ◽  
Hirotsune Kaijima ◽  
Tomoya Segawa ◽  
Masaji Nagaishi ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Average Dose ◽  
Main Mode ◽  
Chorionic Villi ◽  
Surgical Interventions ◽  
Beta Human Chorionic Gonadotropin ◽  
Gestational Sac ◽  
Β Hcg ◽  
Ectopic Pregnancies ◽  
High Beta

Methotrexate has been the main mode of non-surgical treatment for ectopic pregnancies. However, we have developed an easier, repeatable method that can be applied even to patients with a high beta-human chorionic gonadotropin (β-hCG) level and/or positive fetal heartbeat, by targeting chorionic villi with a transvaginal injection of absolute ethanol (AE) into the lacunar space (intervillous space). The efficacy and safety of this method were examined in 242 cases of ectopic pregnancy, including 103 with positive fetal heartbeat. Serum β-hCG level was measured at frequent intervals, and transvaginal ultrasonography was performed to observe the gestational sac and hyperechoic inner ring. Of the 242 patients, 222 (91.7%) were successfully treated. The average number of AE injection(s) required was 1.6 (range: 1–5), and the average dose was 3.2 mL. After the treatment, many of the patients tried to conceive again, and 63 of the traceable 145 patients (43.4%), who had fallopian tube pregnancy, and 7 of the traceable 12 patients (58.3%), who had cervical or cesarean scar pregnancies, successfully conceived and delivered babies with no observed side effects. Therefore, this method could be an effective treatment for ectopic pregnancy with the potential to replace conventional surgical interventions and medical treatment using methotrexate.

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