Recurrent cervical pregnancy after assisted reproduction by intrafallopian transfer.
BACKGROUND
Cervical pregnancy is an uncommon, yet potentially catastrophic form of ectopic pregnancy. Early diagnosis and intervention are important in avoiding short-term and long-term morbidity. Although transcervical embryo transfer is thought to increase the incidence of this phenomenon in patients undergoing in vitro fertilization, its occurrence after intrafallopian transfer is rarely seen.


METHODS
A 43-year-old nulliparous white female with a history of unexplained infertility experienced recurrent cervical pregnancy after two consecutive gamete/zygote intrafallopian transfer cycles. Abnormally rising beta-hCG levels combined with transvaginal sonography helped establish the diagnosis in each case. Intramuscular (IM) methotrexate combined with intra-amniotic potassium chloride successfully treated this condition initially, and IM methotrexate alone was sufficient for successful treatment in the second case.


CONCLUSIONS
Cervical pregnancy may occur with assisted reproductive techniques involving intrafallopian transfer. Early diagnosis may be important for successful treatment of cervical pregnancy with conservative measures. Even in the case of recurrence, prompt intervention may allow for preservation of a patient's future fertility potential.
Qasim
S M
SM
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, USA.
Bohrer
M K
MK
Kemmann
E
E
D000328:Adult; D002584:Cervix Uteri; D005260:Female; D005493:Folic Acid Antagonists / Q000627:therapeutic use; D015181:Gamete Intrafallopian Transfer; D006801:Humans; D008727:Methotrexate / Q000627:therapeutic use; D011189:Potassium Chloride / Q000627:therapeutic use; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D012008:Recurrence; D017388:Zygote Intrafallopian Transfer
D005493:Folic Acid Antagonists; D011189:Potassium Chloride; D008727:Methotrexate