1/33. Simultaneous rupturing heterotopic pregnancy and acute appendicitis in an in-vitro fertilization twin pregnancy.The presentation of acute abdominal pain in young women is not an unusual occurrence in casualty and gynaecology departments. Both acute appendicitis and ectopic pregnancy have to be considered and investigated, as these two conditions are accepted as the most common surgical causes of an acute abdomen. Difficulties in correctly identifying the cause of the pain can be hazardous to the patient and care needs to be taken in obtaining a prompt and accurate diagnosis enabling the most appropriate management. The case report presented here describes the extremely unusual occurrence of both these acute conditions happening simultaneously with the added complication of an ongoing twin pregnancy and it highlights the need to look beyond the most obvious diagnosis and always to expect the unexpected.- - - - - - - - - - ranking = 1keywords = fertilization (Clic here for more details about this article) |
2/33. Heterotopic pregnancy (triplets) following in vitro fertilisation: case report.We report a patient who had in vitro fertilization for secondary infertility due to tubal disease. Following transfer of three embryos, a twin intrauterine and a tubal ectopic pregnancy resulted (heterotopic pregnancy).- - - - - - - - - - ranking = 0.25keywords = fertilization (Clic here for more details about this article) |
3/33. Unilateral ectopic twin pregnancy following an IVF cycle.We report here a 37-year-old woman who underwent ovulation induction and in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) treatment because of infertility who developed vaginal bleeding at the 6th week of gestation. Abdominal ultrasonography was insufficient to distinguish the intrauterine gestational sac. Subsequently, vaginal doppler ultrasonography detected two separate unilateral twin ectopic pregnancies with cardiac activity in both fetuses, which were operated on pelviscopically.- - - - - - - - - - ranking = 0.25keywords = fertilization (Clic here for more details about this article) |
4/33. Twin heterotopic pregnancy after assisted reproduction. A case report.BACKGROUND: Heterotopic pregnancy is a potentially catastrophic form of ectopic pregnancy and is increasing in incidence secondary to assisted reproductive technology. early diagnosis and intervention are important in avoiding short- and long-term morbidity. CASE: A 36-year-old, nulliparous woman became pregnant by in vitro fertilization and embryo transfer. A total of three embryos were transferred. She presented to the emergency room approximately six weeks after transfer with the complaint of severe abdominal pain. Laboratory analysis revealed a decreasing hematocrit with stable vital signs despite continued abdominal pain. On transvaginal ultrasound, two fetal poles were present, with cardiac activity in two of the three gestational sacs. At surgery the patient was found to have a ruptured tubal pregnancy in addition to the intrauterine gestations. Pathologic analysis revealed a twin tubal pregnancy. CONCLUSION: Heterotopic pregnancy should be considered in the differential diagnosis of any patient who becomes pregnant by assisted reproduction techniques and presents with signs and symptoms of ectopic pregnancy.- - - - - - - - - - ranking = 0.25keywords = fertilization (Clic here for more details about this article) |
5/33. Heterotopic pregnancy at 16 weeks of gestation after in-vitro fertilization and embryo transfer.We present an heterotopic pregnancy at 16 weeks of gestation following IVF/ET treatment with the ectopic pregnancy located in the left fallopian tube. Intra-abdominal bleeding secondary to an heterotopic pregnancy, causing acute abdominal pain and hemorrhagic shock, should be included in the differential diagnosis even in the second trimester of pregnancy, especially in patients, achieving conception with the use of assisted reproduction techniques.- - - - - - - - - - ranking = 1keywords = fertilization (Clic here for more details about this article) |
6/33. Simultaneous bilateral tubal pregnancies after in vitro fertilization and embryo transfer: report of a case.Ectopic pregnancies continue to be a major complication of in vitro fertilization and embryo transfer (IVF-ET). A case of bilateral simultaneous tubal pregnancy after IVF-ET is described. The patient underwent ovum pick-up (OPU) through a laparotomy with concomitant pelvic surgery. embryo transfer (ET) was performed two days after OPU; this resulted in bilateral tubal pregnancies, diagnosed and treated one month apart. There are several possible causal mechanisms for the increased rate of ectopic pregnancies following IVF-ET. It is important to recognize that care in the transfer technique, with respect to the catheter position and limiting the volume of transfer medium to 20 microL, and an awareness of previous occlusion of the tubal ostia, or of a salpingectomy before IVF-ET, can help to minimize this complication rate. Two important points are the possibility of a simultaneous bilateral tubal pregnancy after IVF-ET, and the necessity of carefully examining both adnexa at the time of surgery for an ectopic pregnancy. Early and accurate diagnosis of a simultaneous bilateral ectopic pregnancy can prevent the necessity of a second operation and reduce maternal morbidity and mortality.- - - - - - - - - - ranking = 1.25keywords = fertilization (Clic here for more details about this article) |
7/33. Ruptured heterotopic pregnancy presenting with relative bradycardia in a woman not receiving reproductive assistance.We report a case of heterotopic pregnancy in a woman who had not undergone in vitro fertilization or any other reproductive assistance. The patient failed to mount a tachycardic response to hemorrhagic shock. bradycardia is a well-established phenomenon in the setting of hemoperitoneum and particularly with ruptured ectopic pregnancy. This is a case of heterotopic pregnancy with relative bradycardia in a woman without predisposing factors for heterotopic pregnancy. We make suggestions on avoiding common pitfalls in the emergency department diagnosis of heterotopic pregnancy. We also address the similar clinical presentations of heterotopic pregnancy and intrauterine pregnancy with ruptured corpus luteum cyst.- - - - - - - - - - ranking = 0.25keywords = fertilization (Clic here for more details about this article) |
8/33. A case of simultaneous tubal-splenic pregnancy after assisted reproductive technology.OBJECTIVE: To present a case of simultaneous splenic and tubal pregnancy following in vitro fertilization. DESIGN: Case report. SETTING: University hospital. PATIENT(S): A 37-year-old woman who had undergone in vitro fertilization and embryo transfer for unexplained infertility at another clinic. INTERVENTION(S): laparoscopy and laparotomy. MAIN OUTCOME MEASURE(S): serum concentration of human chorionic gonadotropin (hCG) after salpingosplenectomy. RESULT(S): After transfer of three embryos following fertilization by intracytoplasmic sperm injection (ICSI) at another clinic, the patient was referred to our hospital with suspicion of ectopic pregnancy. Because tubal pregnancy was suspected, laparoscopic right salpingectomy was performed. Although villi were detected in the resected fallopian tube, the serum hCG concentration did not decrease after the operation and a new intraabdominal hemorrhage was detected. We then suspected abdominal pregnancy in the epigastric region, and performed magnetic resonance imaging, computed tomography, and ultrasound examinations, which revealed implantation at the inferior pole of the spleen. splenectomy was performed, with the resulting disappearance of intraabdominal hemorrhage and rapid fall of the serum concentration of hCG. CONCLUSION(S): Assisted reproduction sometimes results in heterotopic pregnancy, but an abdominal pregnancy involving the upper abdominal organs is considered extremely rare. Particularly, splenic pregnancy is usually overlooked and may only be discovered after a sudden intraabdominal hemorrhage. If hemorrhaging is present in the abdominal cavity but pregnancy is not detected within the pelvis, it is advisable to examine patients using imaging techniques to detect any upper abdominal pregnancies.- - - - - - - - - - ranking = 0.75keywords = fertilization (Clic here for more details about this article) |
9/33. Simultaneous ectopic pregnancy with intra-uterine gestation after in vitro fertilization and embryo transfer.A case of combined intra-uterine and tubal ectopic pregnancy is described following in vitro fertilization and the transfer of two four-cell and one two-cell embryos. This phenomenon is known to be related to ovarian stimulation by gonadotropin therapy, and there is an increased risk with tubal disease. Techniques applied at the time of embryo transfer, the use of culture medium with 50% fetal cord serum to convey the embryos to the uterus, the catheterization method, and the position of the patient during transfer are presented. The risk of multiple pregnancies and combined intra-uterine and ectopic gestations increases with numbers of transfers and large volume of transfer medium. We would therefore recommend that after IVF-ET treatment in women with tubal disease, intensive care should be taken in the early follow-up period to rule out the possibility of ectopic pregnancy. In this case, a viable ongoing intra-uterine pregnancy was confirmed after surgery for right ampullary ectopic pregnancy. And a 2,925 g male in excellent condition was delivered by cesarean section without complications.- - - - - - - - - - ranking = 1.25keywords = fertilization (Clic here for more details about this article) |
10/33. Second-trimester heterotopic pregnancy after in vitro fertilization and embryo transfer--a case report and review of the literature.Seven cases of heterotopic pregnancies following in vitro fertilization (IVF) and embryo transfer (ET) have been seen. In these cases, concomitant intrauterine and extrauterine pregnancies were described in the first trimester. We present the first case of second-trimester heterotopic pregnancy after IVF with successful surgical treatment of the ectopic pregnancy and subsequent full-term birth of the intrauterine pregnancy. The etiologic factors, possible explanation for the relatively frequent occurrence of heterotopic pregnancies in IVF, and the diagnostic difficulties are presented.- - - - - - - - - - ranking = 1.25keywords = fertilization (Clic here for more details about this article) |
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