title: An unexpected quadruplet heterotopic pregnancy after bilateral salpingectomy and replacement of three embryos.
abstract: OBJECTIVE
  To report a case of combined intrauterine and interstitial twin pregnancies after bilateral salpingectomy and IVF with replacement of three embryos.
  
  
  METHODS
  Case report.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  A 31-year-old woman known to have bilateral salpingectomy for ectopic pregnancies who underwent IVF.
  
  
  METHODS
  Laparotomy.
  
  
  METHODS
  Postoperation intrauterine monozygotic twins survival and birth.
  
  
  RESULTS
  After removing the interstitial monozygotic twin pregnancy, the patient had an uneventful postoperative course and delivered two healthy girls by cesarean section at 38 weeks' gestation.
  
  
  CONCLUSIONS
  Heterotopic pregnancy can still occur in women treated by IVF after bilateral salpingectomy. The early sonography follow-up of IVF pregnancy would be of value because of the reported higher incidence of pathological pregnancies and especially monozygotic twinning.
authors.affiliation: Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Chang
authors.forename: Jau Nan
authors.initials: JN
authors.lastname: Lee
authors.forename: Cheng Hui
authors.initials: CH
authors.lastname: Yang
authors.forename: Shih Cheng
authors.initials: SC
authors.lastname: Hsu
authors.forename: Eing Mei
authors.initials: EM
authors.lastname: Tsai
mesh_terms: D000328:Adult; D004624:Embryo Transfer / Q000009:adverse effects*; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects*; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome; D011271:Pregnancy, Ectopic / Q000209:etiology*; D011272:Pregnancy, Multiple; D011783:Quadruplets; D014430:Twins, Monozygotic; D016216:Ultrasonography, Prenatal