Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 16, 2021; 9(23): 6950-6955
Published online Aug 16, 2021. doi: 10.12998/wjcc.v9.i23.6950
Post-salpingectomy interstitial heterotopic pregnancy after in vitro fertilization and embryo transfer: A case report
Qiao Wang, Xiao-Ling Pan, Xiao-Rong Qi
Qiao Wang, Xiao-Ling Pan, Xiao-Rong Qi, Department of Gynecology and Obstetrics, West China Second Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Wang Q and Pan XL performed the research; Wang Q wrote the manuscript; Qi XR performed the surgery and revised the manuscript; all authors have read and approve the final manuscript.
Informed consent statement: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.
Conflict-of-interest statement: All authors declare no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Rong Qi, MD, Assistant Professor, Department of Gynecology and Obstetrics, West China Second Hospital, Sichuan University, No. 20 Renmin Road, Chengdu 610041, Sichuan Province, China. 66518456@qq.com
Received: May 9, 2021
Peer-review started: May 9, 2021
First decision: June 5, 2021
Revised: June 6, 2021
Accepted: June 22, 2021
Article in press: June 22, 2021
Published online: August 16, 2021
Abstract
BACKGROUND

Heterotopic pregnancy (HP) refers to the coexistence of ectopic pregnancy and intrauterine pregnancy. Salpingectomy is proposed as a pretreatment before in vitro fertilization and embryo transfer (IVF-ET) to reduce the risk of HP. HP after IVF-ET occurs in women who had already underwent bilateral salpingectomy, even though it is extremely rare.

CASE SUMMARY

A case of a 29-year-old woman with recurrent interstitial HP after IVF-ET following salpingectomy is presented. The main symptom was a sudden and worsening pelvic pain. Physical examinations revealed signs of peritoneal bleeding and irritation with stable vital signs. Transvaginal ultrasound showed a live intrauterine pregnancy and another live embryo with cardiac activity in the left cornu extending beyond the lateral edge of the uterus. Her hemoglobin concentration was 8.0 g/dL, and serum human chorionic gonadotropin value was 171116.9 mIU/mL. With the diagnosis of ruptured HP with internal bleeding, an emergency laparoscopic resection of left cornu was performed. The interstitial pregnancy was removed with caution to protect the intrauterine pregnancy. After the surgical treatment, the intrauterine pregnancy continued with no complications. A healthy baby was delivered by caesarean section at 39 wk. Outcomes of another three cases are further summarized.

CONCLUSION

Post-salpingectomy HP is a rare but challenging condition. Surgical treatment is preferred in the case with a viable intrauterine pregnancy.

Keywords: Heterotopic pregnancy, In vitro fertilization and embryo transfer, Salpingectomy, Surgery, Case report

Core Tip: Our paper presented a rare case of a 29-year-old woman with recurrent interstitial heterotopic pregnancy (HP) after in vitro fertilization-embryo transfer following bilateral salpingectomy. We also summarized the outcomes of another three similar cases successfully treated in our department. Furthermore, we reviewed characteristics and outcomes of other reported post-salpingectomy HP cases. Interstitial HP after bilateral salpingectomy is extremely rare and has a high risk of rupture and hemorrhage.