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.

Design: Case report.

Setting: University hospital.

Patient(s): A 31-year-old woman known to have bilateral salpingectomy for ectopic pregnancies who underwent IVF.

Intervention(s): Laparotomy.

Main outcome measure(s): Postoperation intrauterine monozygotic twins survival and birth.

Result(s): 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.

Conclusion(s): 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.