Unilateral triplet ectopic pregnancy after in vitro fertilization and embryo transfer.
OBJECTIVE
To present a case report of a unilateral triplet ectopic pregnancy (EP) conceived by IVF-embryo transfer.


METHODS
Case report.


METHODS
University Hospital, Budapest, Hungary.


METHODS
A 26-year-old infertile woman with a history of right salpingectomy, hyperprolactinemia, and male factor infertility underwent IVF-embryo transfer of three embryos. Early transvaginal sonography revealed a triplet pregnancy in the left fallopian tube (two at interstitial and one at ampullary location).


METHODS
Multiple dose methotrexate (MTX) therapy was applied.


METHODS
Follow-up pelvic ultrasounds and laboratory testing confirmed fetal cardiac activity cessation and decreasing beta-hCG levels.


RESULTS
In spite of the decreasing beta-hCG levels the tube's diameter increased, the patient's symptoms escalated, and finally, the level of hemoglobin and hematocrit decreased. Laparotomy was performed with the removal of the left tube and cornual part of the uterus.


CONCLUSIONS
Our case represents a very rare condition, a unilateral triplet EP after IVF-embryo transfer-the first one ever reported in the literature. After IVF-embryo transfer early ultrasound examinations are important to identify EPs at an early stage when medical management can still be taken into consideration. Strict monitoring is necessary to identify the success of medical intervention or the need for surgery.
Berkes
Eniko
E
First Department of Obstetrics and Gynaecology, Semmelweis University, Budapest, Hungary. eniko.berkes@mail.datanet.hu
Szendei
Gyorgy
G
Csabay
Laszlo
L
Sipos
Zsuzsanna
Z
Joo
Jozsef Gabor
JG
Rigo
Janos
J
D000020:Abortifacient Agents, Nonsteroidal / Q000627:therapeutic use; D000032:Abortion, Therapeutic; D000328:Adult; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D013509:Gynecologic Surgical Procedures; D006801:Humans; D008727:Methotrexate / Q000627:therapeutic use; D011247:Pregnancy; D011272:Pregnancy, Multiple; D011274:Pregnancy, Tubal / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000378:metabolism / Q000628:therapy; D016896:Treatment Outcome; D014310:Triplets; D016216:Ultrasonography, Prenatal
D000020:Abortifacient Agents, Nonsteroidal; D018997:Chorionic Gonadotropin, beta Subunit, Human; D008727:Methotrexate