title: Triplet heterotopic pregnancy after gonadotropin stimulation and intrauterine insemination diagnosed at laparoscopy: a case report.
abstract: Heterotopic pregnancy has been traditionally considered a rare event; however, with the use of assisted reproductive technology, the incidence of heterotopic pregnancies is increasing. Diagnosing a heterotopic pregnancy can be challenging. This report describes a 30-year-old female at 11 weeks' gestation with an intrauterine twin pregnancy after gonadotropin stimulation and intrauterine insemination who presented complaining of left lower quadrant abdominal pain with constipation and cramps. The patient was empirically treated for diverticulitis but failed to respond to therapy. A heterotopic triplet pregnancy was ultimately diagnosed at laparoscopy. Heterotopic pregnancy must be considered in the differential diagnosis of abdominal pain in the first trimester, especially in patients who conceived by means of assisted reproductive technology. Surgical treatment is the most frequently used method of treatment.
authors.affiliation: Department of Obstetrics and Gynecology, Mercer University School of Medicine, Memorial Health University Medical Center, Savannah, GA 31404, USA. alex_j_childs@yahoo.com
authors.forename: Alex J
authors.initials: AJ
authors.lastname: Childs
authors.forename: Anthony B
authors.initials: AB
authors.lastname: Royek
authors.forename: T Brian
authors.initials: TB
authors.lastname: Leigh
authors.forename: Pamela G
authors.initials: PG
authors.lastname: Gallup
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D003951:Diagnostic Errors; D004238:Diverticulitis / Q000175:diagnosis; D005260:Female; D006801:Humans; D010535:Laparoscopy; D010062:Ovulation Induction / Q000009:adverse effects*; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000175:diagnosis* / Q000209:etiology* / Q000601:surgery; D011272:Pregnancy, Multiple; D014310:Triplets