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Case Reports
. 2023 Jul;48(4):425-429.
doi: 10.30476/IJMS.2022.94399.2574.

Quadruplet Heterotopic Pregnancy Following In Vitro Fertilization and Embryo Transfer with Laparotomic Removal of Ruptured Twin Tubal Ectopic Pregnancy: A Case Report

Mehran Anjomrooz  1 , Maryam Farid Mojtahedi  2 , Mahboubeh Abedi  3
Affiliations
Case Reports

Quadruplet Heterotopic Pregnancy Following In Vitro Fertilization and Embryo Transfer with Laparotomic Removal of Ruptured Twin Tubal Ectopic Pregnancy: A Case Report

Mehran Anjomrooz et al. Iran J Med Sci. 2023 Jul.

Abstract

Heterotopic pregnancy (HP) is a rare occurrence in natural pregnancies. However, it can be a life-threatening condition and should be taken into account in all assisted reproductive treatments. Diagnosis and treatment of ectopic pregnancy are challenging issues in patients with HP. Here, we report a rare case of quadruplet HP following an in vitro fertilization-embryo transfer with a viable twin intrauterine pregnancy and ruptured live twin left tubal ectopic pregnancy. A 35-year-old woman (gravida 5, para 1, ectopic pregnancies 2, and abortion 1) was presented to the Emergency Department of Arash Women's Hospital (Tehran, Iran) in March 2021 with abdominal pain. The patient was at six weeks and five days of pregnancy following in vitro fertilization-embryo transfer. Transvaginal sonography (TVS) revealed a live twin intrauterine pregnancy with a ruptured live twin left tubal ectopic pregnancy. The latter was removed via laparotomy to preserve the intrauterine pregnancy. The patient subsequently delivered a female infant at 38 weeks of pregnancy.

Keywords: Assisted; Embryo transfer; Fertilization in vitro; Quadruplets; Reproductive techniques.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
Transvaginal ultrasound showed live twin intrauterine pregnancies in separate gestational sacs. Yellow arrows show the two intrauterine fetal poles with cardiac activity.
Figure 2
Figure 2
Transvaginal ultrasound showed left adnexal mass containing live twin ectopic pregnancies in separate gestational sacs. Red arrows show the two live fetuses within the mass of ectopic pregnancy.
Figure 3
Figure 3
Transabdominal ultrasound in the third trimester showed a live fetus with normal growth.
See this image and copyright information in PMC

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