Human Reproduction, Vol. 16, No. 10, 2227-2229,
October 2001
© 2001 European Society of Human Reproduction and Embryology
Rare association of ovarian implantation site for patients with heterotopic and with primary ectopic pregnancies after ICSI and blastocyst transfer
Case report
Clínica e Centro de Pesquisa em Reprodução Humana `Roger Abdelmassih', Rua Maestro Elias Lobo, 805 01433–000, São Paulo, Brazil
Two cases of patients with ruptured ovarian pregnancies (P1 = ovarian heterotopic and P2 = primary ovarian ectopic) after intracytoplasmic sperm injection and blastocyst transfer are presented. Laparoscopy was performed on day 40 and day 27 after transfer in cases P1 and P2 respectively. In both cases the ectopic pregnancies were located on the left ovary and were successfully removed by laparoscopy preserving the ovaries. In case P1 the intrauterine pregnancy was not affected. A healthy boy was born after 37 weeks of pregnancy. In this way, potential fertility of the patients and the intrauterine pregnancy were maintained. These cases occurred during a series of blastocyst transfers in which 129 pregnancies were obtained. There were no cases of ovarian ectopic/heterotopic pregnancies from January 1996 to September 1999 in 814 pregnancies obtained from day 2 or day 3 embryo transfers. Because the ovarian ectopic pregnancies occurred in patients with day 5 embryo transfer who otherwise did not have any predisposing factors for ectopic pregnancy, it is advisable to conduct a large scale analysis of future data about the possible association between blastocyst-stage embryo transfer and the somewhat higher risk of unexpected complications of clinical outcome.
Key words: blastocyst/heterotopic pregnancy/ICSI/IVF/ovarian pregnancy
1 To whom correspondence should be addressed at: Clínica e Centro de Pesquisa em Reprodução Humana `Roger Abdelmassih'. Rua Maestro Elias Lobo, 805 01433–000, São Paulo, Brazil. E-mail: flaviogo2{at}uol.com.br