title: An unexpected triplet heterotopic pregnancy after replacement of two embryos.
abstract: We report a case of a triplet heterotopic pregnancy consisting of an intrauterine monozygous twin pregnancy and a tubal pregnancy after replacement of only two embryos in an in-vitro fertilization cycle with donor spermatozoa. This case demonstrates that sonographic demonstration of two intrauterine pregnancies after transfer of two embryos does not exclude the presence of an ectopic pregnancy. As both heterotopic pregnancy and spontaneous monozygotic twinning are more frequent after the use of assisted reproductive techniques, this combination, although extremely rare, must be kept in mind, especially in older patients with pre-existing tubal damage.
authors.affiliation: Department of Obstetrics, Gynaecology and Fertility, Middelheim Hospital, Antwerp, Belgium.
authors.forename: I
authors.initials: I
authors.lastname: Inion
authors.forename: J
authors.initials: J
authors.lastname: Gerris
authors.forename: M
authors.initials: M
authors.lastname: Joostens
authors.forename: B
authors.initials: B
authors.lastname: De Vree
authors.forename: M
authors.initials: M
authors.lastname: Kockx
authors.forename: P
authors.initials: P
authors.lastname: Verdonk
mesh_terms: D000328:Adult; D020964:Embryo Loss; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D011271:Pregnancy, Ectopic / Q000175:diagnosis*; D011272:Pregnancy, Multiple; D011374:Progesterone / Q000008:administration & dosage; D014427:Twins; D014430:Twins, Monozygotic; D016216:Ultrasonography, Prenatal
chemical_list: D011374:Progesterone