Heterotopic pregnancy after bilateral salpingectomy, IVF and multiple embryos transfer. A case report and systematic review of the literature

J Obstet Gynaecol. 2022 Jul;42(5):809-815. doi: 10.1080/01443615.2021.2001794. Epub 2022 Jan 12.

Abstract

Heterotopic pregnancy after bilateral salpingectomy is an extremely rare complication of in vitro fertilisation/embryo transfer cycles. We report a case of a ruptured abdominal pregnancy on the omentum which was the stimulus to conduct the first systematic review on this complication according to 'PRISMA' guidelines (PROSPERO R.No CRD42020134104). PubMed, EMBASE and OpenAIRE databases were systematically reviewed for studies reporting (a) cases or case series of, (b) heterotopic pregnancies after, (c) prior bilateral salpingectomy, and (d) embryo transfer cycles. Twenty-two articles met the selection criteria including, with our case, 28 cases. Based on the results, clinical manifestations and laboratory findings can be unspecific or misleading. Transvaginal ultrasound is the main diagnostic tool as the ectopic foetus is more frequently located in the intramural part of the fallopian tubes, the tubal stump or the ovaries. Laparotomy or laparoscopy are the main treatment options with adequate perinatal outcome.

Keywords: Heterotopic pregnancy; IVF; abdominal pregnancy; bilateral salpingectomy; embryo transfer.

Publication types

  • Case Reports
  • Systematic Review

MeSH terms

  • Embryo Transfer / adverse effects
  • Fallopian Tubes
  • Female
  • Fertilization in Vitro / adverse effects
  • Humans
  • Pregnancy
  • Pregnancy, Heterotopic* / diagnosis
  • Pregnancy, Heterotopic* / etiology
  • Pregnancy, Heterotopic* / surgery
  • Pregnancy, Tubal* / etiology
  • Pregnancy, Tubal* / surgery
  • Salpingectomy / adverse effects