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Ovarian Ectopic Pregnancy After In Vitro Fertilization
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Ovarian Ectopic Pregnancy After In Vitro Fertilization Caitlin Dunne, MD,1 Jon C. Havelock, MD1,2 1
Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC
2
Pacific Centre for Reproductive Medicine (PCRM), Vancouver BC
O
varian ectopic pregnancy is even more rare after in vitro fertilization and embryo transfer (IVF-ET) than natural conception, with a reported incidence of 7:2745 IVF-ET pregnancies.1,2 A 34-year-old gravida 2, abortus 1 woman with infertility and patent fallopian tubes underwent IVF-ET. Two embryos, culture day 5, were transferred and placement within the uterus was confirmed with ultrasound. The patient’s β-hCG rose appropriately on post-ET days 9 and 11 (75 to 146 U/L). She remained asymptomatic throughout the pregnancy. Routine ultrasound performed at 7 weeks plus 2 days’ gestational age demonstrated an empty uterine cavity and a 1 cm embryo in the right adnexa with a fetal heart rate and visible yolk sac. At laparoscopy, a right ovarian ectopic
Figure 1. Ultrasound of the right ovarian ectopic pregnancy.
pregnancy was seen arising from the tip of the ovary. The pregnancy was resected and the patient’s β-hCG level had decreased to 1 U/L by 6 weeks postoperative. REFERENCES 1. Marcus SF, Brinsden PR. Primary ovarian pregnancy after in vitro fertilization and embryo transfer: Report of 7 cases. Fertil Steril 1993;60:167–9. 2. Geber S, Barroso R, Pereira D, Sampaio M. Case report: ovarian pregnancy after IVF-ET in a patient with absent tube. J Assist Reprod Genet 2001;18:665–7.
J Obstet Gynaecol Can 2012;34(5):409
Figure 2. Laparoscopic image showing the right ectopic pregnancy arising from the tip of the ovary.
MAY JOGC MAI 2012 l 409
Ovarian Ectopic Pregnancy After In Vitro Fertilization Caitlin Dunne, MD,1 Jon C. Havelock, MD1,2 1
Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC
2
Pacific Centre for Reproductive Medicine (PCRM), Vancouver BC
O
varian ectopic pregnancy is even more rare after in vitro fertilization and embryo transfer (IVF-ET) than natural conception, with a reported incidence of 7:2745 IVF-ET pregnancies.1,2 A 34-year-old gravida 2, abortus 1 woman with infertility and patent fallopian tubes underwent IVF-ET. Two embryos, culture day 5, were transferred and placement within the uterus was confirmed with ultrasound. The patient’s β-hCG rose appropriately on post-ET days 9 and 11 (75 to 146 U/L). She remained asymptomatic throughout the pregnancy. Routine ultrasound performed at 7 weeks plus 2 days’ gestational age demonstrated an empty uterine cavity and a 1 cm embryo in the right adnexa with a fetal heart rate and visible yolk sac. At laparoscopy, a right ovarian ectopic
Figure 1. Ultrasound of the right ovarian ectopic pregnancy.
pregnancy was seen arising from the tip of the ovary. The pregnancy was resected and the patient’s β-hCG level had decreased to 1 U/L by 6 weeks postoperative. REFERENCES 1. Marcus SF, Brinsden PR. Primary ovarian pregnancy after in vitro fertilization and embryo transfer: Report of 7 cases. Fertil Steril 1993;60:167–9. 2. Geber S, Barroso R, Pereira D, Sampaio M. Case report: ovarian pregnancy after IVF-ET in a patient with absent tube. J Assist Reprod Genet 2001;18:665–7.
J Obstet Gynaecol Can 2012;34(5):409
Figure 2. Laparoscopic image showing the right ectopic pregnancy arising from the tip of the ovary.
MAY JOGC MAI 2012 l 409