10 October 2024
: Case report 
Recurrent Heterotopic Pregnancy Following Frozen-Thawed Embryo Transfer: A Case Study and Comprehensive Literature Review
Mistake in diagnosis, Management of emergency care, Rare disease
Yonghuan Lv12ACDE, Wenyan Tian12ADG, Xueru Song12AD, Ye Tian12CDF, Kan Wang12BCF, Fengxia Xue12AG*DOI: 10.12659/AJCR.945053
Am J Case Rep 2024; 25:e945053
Table 1. Review of recurrent heterotopic pregnancy cases in the literature.
| Author (year) | Raziel (1997) | Ben-Ami (2006) | Shavit (2013) | Present case |
|---|---|---|---|---|
| Age, years | 27 | 35 | 35 | 32 |
| Gravidity | 0 | NA | 0 | 1 |
| History | IUI (8 times) | NA | Bilateral tubal resection | Induced abortion (once) |
| Fallopian tube condition | Bilateral tubal patency | NA/Bilateral fallopian tubes removed | Bilateral fallopian tubes removed | Patent left fallopian tube; proximal obstruction in the right fallopian tube |
| ART method | ICSI/ICSI | NA/IVF | IVF/IVF | HRT-FET/NC-FET |
| Number of transferred embryoes | 4/4 | NA/3 | 2/2 | 2/2 |
| β-HCG (mIU/mL) | 151 (14 d after ET)/183 (14 d after ET) | NA/NA | 300 (12 d after ET) and 655 (14 d after ET)/109 (12 d after ET) and 266 (14 d after ET) | 896.42 (14 d after ET) and 1637.55 (16 d after ET)/2180.47 (14 d after ET) and 5662.4 (16 d after ET) |
| Weeks between ET and the diagnosis | 8/8 | NA/7 | 7/6 | 10 wk, 3 d/8 wk, 3 d |
| Symptoms | Acute abdomen/Vaginal spotting and mild abdominal discomfort | NA/Acute abdomen | Acute abdomen/NA | Vaginal bleeding/Asymptomatic |
| Fetal cardiac activity during the IUP before treatment | Yes/Yes | NA/Yes | Yes/Yes | No/Yes |
| Site of ectopic pregnancy | Left tubal ampulla/Right tubal ampulla | Unilateral fallopian tube/Right tubal stump | Right tubal stump/Left tubal stump | Right tubal ampulla/Left tubal ampulla |
| Treatment | Laparotomy salpingectomy/Laparoscopic salpingectomy | Laparoscopic bilateral salpingectomy/Laparoscopic tubal stump resection | Laparoscopic tubal stump resection/Laparoscopic tubal stump resection | Laparoscopic salpingectomy and D&C/Laparoscopic salpingectomy |
| Outcome of IUP | Missed abortion/Live birth | Missed abortion/Live birth | Missed abortion/Spontaneous abortion | D&C/Live birth |
| Note | No abnormalities were observed in the adnexa during the ultrasonography examinations at 7 weeks of gestation | No details | NA | No abnormalities were observed in the adnexa during three ultrasonography examinations (first HP) |
| Information before the slash (/) pertains to the first HP; information after the slash pertains to the subsequent HP. β-HCG – β-human chorionic gonadotropin; EP – ectopic pregnancy; ET – embryo transfer; HP – heterotopic pregnancy; HRT-FET – hormone replacement therapy and frozen-thawed embryo transfer; ICSI – intracytoplasmic sperm injection; IUI – intrauterine insemination; IUP – intrauterine pregnancy; IVF – in vitro fertilization; NA – not available; NC-FET – natural cycle frozen-thawed embryo transfer. | ||||