Double trouble: a rare case of bilateral ectopic pregnancy following intracytoplasmic sperm injection
Keywords:Bilateral ectopic, ICSI pregnancy, bilateral salpingectomy
AbstractBilateral 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.
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