Double trouble: a rare case of bilateral ectopic pregnancy following intracytoplasmic sperm injection


  • Tejal Poddar 21st Century Fertility Centre, Surat, Gujarat, India
  • Pooja Nadkarni Singh 21st Century Fertility Centre, Surat, Gujarat, India
  • Purnima Nadkarni 21st Century Fertility Centre, Surat, Gujarat, India



Bilateral ectopic, ICSI pregnancy, bilateral salpingectomy


Bilateral tubal pregnancy is a rare clinical condition which occurs in only 1 per 200,000 pregnancies. The common risk factors are assisted reproductive technique, pelvic infection and tubal surgery. Such unusual cases may go undiagnosed and the consequences can be devastating. We present one such rare case of bilateral tubal pregnancy in a woman who underwent IVF treatment. A 41-year-old woman who had secondary infertility was admitted with ultrasonography suggestive of ectopic pregnancy. The couple had opted for ovum donation with ICSI due to low ovarian reserve. In the next ICSI cycle, three 4-cell grade A (excellent grade) transferred 72 hours after oocyte retrieval. Two weeks after ET, the patient’s first β-hCG level was 345 mIU/ml. Following which second β-hCG was 2177 mlU/ml on day 20 after ET. Upon ultrasound examination no intrauterine pregnancy could be visualized. Approximately 7-8 mm sized unruptured ectopic gestation sac was visualized in right adnexa. She did not experience any vaginal bleeding or pain and was haemodynamically stable. Laparoscopy was performed and it revealed bilateral ectopic pregnancy. Bilateral salpingectomy was performed.


De Los Ríos JF, Castaneda JD, Miryam A. Bilateral ectopic pregnancy. J Minim Invasive Gynecol. 2007;14(4):419-27.

Stabile I, Grudzinskas JG. Ectopic pregnancy: a review of incidence, etiology and diagnostic aspects. Obstet Gynecol Surv. 1990;45(6):335-47.

Jonler M, Rasmussen KL, Lundorff P. Coexistence of bilateral tubal and intrauterine pregnancy. Acta Obstet Gynecol Scand. 1995;74:750-2.

Steptoe PC, Edwards RG. Reimplantation of a human embryo with subsequent tubal pregnancy. Lancet. 1976;1(7965):880-2.

Trotnow S, Al-Hasani S, Hünlich T, Schill WB. Bilateral tubal pregnancy following in vitro fertilization and embryo transfer. Arch Gynecol. 1983;234(1):75-8.

Hewitt J, Martin R, Steptoe PC, Rowland GF, Webster J. Bilateral tubal ectopic pregnancy following in-vitro fertilization and embryo replacement. Case report. Br J Obstet Gynaecol. 1985;92(8):850-2.

Herman A, Ron-El R, Golan A, Weinraub Z, Bukovsky I, Caspi E. The role of tubal pathology and other parametersin ectopic pregnancies occurring in in vitro fertilization and embryo transfer. Fertil Steril. 1990;54:864-8.

Schwarzler P, Zech H, Auer M. Pregnancy outcome after blastocyst transfer as compared to early cleavage stage embryo transfer. Hum Reprod. 2004;19:2097-102.

Yanaihara A, Yorimitsu T, Motoyama H, Ohara M, Kawamura T. Clinical outcome of frozen blastocyst transfer; single vs. double transfer. J Assist Reprod Genet. 2008;25:531-4.

Milki AA, Jun SH. Ectopic pregnancy rates with day 3 versus day 5 embryo transfer: a retrospective analysis. BMC Pregnancy Childbirth. 2003;3:7.






Case Reports