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      • Record: found
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      An abdominal ectopic pregnancy following a frozen-thawed ART cycle: a case report and review of the literature

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          Abstract

          Background

          Ectopic pregnancy (EP) occurs in 1% of pregnancies and is reported to be more common in in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) pregnancies. An abdominal ectopic pregnancy (AEP) is a rare form of EP, and there are few reports of an AEP after IVF/ICSI. In this case report, a rare case of AEP after frozen-thawed cycle of ICSI is presented.

          Case presentation

          After a frozen-thawed cycle of ICSI, the beta-human chorionic gonadotropin (HCG) level at 4 weeks 0 days of gestation was 3.4 IU/L. Subsequent dysfunctional uterine bleeding was mistaken for menstruation; however, an AEP of 9 weeks with a fetal heart beat was observed by ultrasound. After the AEP was observed by ultrasound, it was extracted laparoscopically.

          Conclusion

          A rare case of an AEP, which developed after frozen-thawed cycle of ICSI, presented with a very low serum HCG level. Even if the HCG titer is low, follow-up HCG levels and frequent medical examinations are necessary.

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          Most cited references41

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          Risk factors for ectopic pregnancy: a multi-center case-control study

          Cheng-Cheng Li, Wei-Hong Zhao, Qian Zhu … (2015)
          Background Ectopic pregnancy (EP) is the leading cause of maternal death during the first trimester of pregnancy. A better understanding of EP risk can help prevent its occurrence. We carried out a multi-center, large-sample, case-control study to evaluate the risk factors for EP in Shanghai, China. Methods Women who were diagnosed with EP (n = 2411) and women with intrauterine pregnancies (n = 2416) were recruited from five hospitals in Shanghai, China. Information regarding the sociodemographic characteristics; reproductive, gynecological and surgical history; and previous and current use of contraceptives was collected from all participants. Odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated and adjusted for potential confounding factors via multivariate logistic regression analysis. Results The study revealed that the risk of EP was associated with the traditional risk factors including previous EP (Adjusted odds ratio [AOR] = 2.72, 95 % CI: 1.83–4.05), previous Chlamydia trachomatis infection (Adjusted OR = 3.18, 95 % CI: 2.64, 3.84), previous infertility (AOR = 2.18, 95 % CI: 1.66–2.88), previous adnexal surgery (AOR = 2.09, 95 % CI: 1.49–2.93), previous appendectomy (AOR = 1.64, 95 % CI: 1.13–2.37), and previous use of intrauterine devices (IUDs) (AOR = 1.72, 95 % CI: 1.39–2.13). Additionally, EP risk was increased following the failure of most contraceptives used in the current cycle including IUDs (AOR = 16.43, 95 % CI: 10.42–25.89), oral contraceptive pills (AOR = 3.02, 95 % CI: 1.16–7.86), levonorgestrel emergency contraception (AOR = 4.75, 95 % CI: 3.79–5.96), and female sterilization (AOR = 4 .73, 95 % CI: 1.04–21.52). Stratified analysis showed that in vitro fertilization and embryo transfer (IVF-ET) was the main risk factor for EP in women with tubal infertility (AOR = 8.99, 95 % CI: 1.98–40.84), although IVF-ET showed no association with EP in women with non-tubal infertility (AOR = 2.52, 95 % CI: 0.14–44.67). Conclusion In addition to the traditional risk factors, IVF-ET and current IUD use play dominant roles in the occurrence of EP. Attention should be given to women with tubal infertility who have undergone IVE-ET treatment.
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            Is frozen embryo transfer cycle associated with a significantly lower incidence of ectopic pregnancy? An analysis of more than 30,000 cycles.

            Bo Huang, Dan Hu, Kun Qian … (2014)
            To analyze the incidence of ectopic pregnancy (EP) in fresh compared with frozen-thawed cycles.
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              Ectopic pregnancy after in vitro fertilization: differences between fresh and frozen-thawed cycles.

              Laura Londra, Caroline Moreau, Donna Strobino … (2015)
              To evaluate whether the uterine environment is associated with the risk of ectopic implantation by comparing outcomes of fresh and frozen-thawed embryo transfers.
              Article 0 comments Cited 32 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Atsushi Yanaihara: +81-467-50-0112 , at123y@yahoo.co.jp
                Shirei Ohgi: ougi@yanaihara.jp
                Kenichirou Motomura: alexnicholas1964jbcc12022005@softbank.ne.jp
                Yuko Hagiwara: gin2_0515@yahoo.co.jp
                Tae Mogami: e973057@yahoo.co.jp
                Keisuke Saito: saitouk88@live.com
                Takumi Yanaihara: takumi-y@bc4.so-net.ne.jp
                Journal
                Journal ID (nlm-ta): BMC Pregnancy Childbirth
                Journal ID (iso-abbrev): BMC Pregnancy Childbirth
                Title: BMC Pregnancy and Childbirth
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1471-2393
                Publication date (Electronic): 7 April 2017
                Publication date PMC-release: 7 April 2017
                Publication date Collection: 2017
                Volume: 17
                Electronic Location Identifier: 108
                Affiliations
                [1 ]Yanaihara Women’s Clinic, 1-26-29 Ofuna, Kamakura, Kanagawa Zip247-0056 Japan
                [2 ]GRID grid.470126.6, Department of Obstetrics & Gynecology, Women’s Health, , Yokohama City University Hospital, ; 3-9 Fukuura Kanazawa-ku, Yokohama, Zip 236-0004 Japan
                Article
                Publisher ID: 1294
                DOI: 10.1186/s12884-017-1294-8
                PMC ID: 5383944
                PubMed ID: 28388882
                SO-VID: ab011445-67e8-457f-8d08-df29af5b989a
                Copyright © © The Author(s). 2017
                License:

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Date received : 5 May 2016
                Date accepted : 24 March 2017
                Categories
                Subject: Case Report
                Custom metadata
                issue-copyright-statement © The Author(s) 2017

                ScienceOpen disciplines: Obstetrics & Gynecology
                Keywords: abdominal ectopic pregnancy,hcg,laparoscope,ivf,case report
                Data availability:
                ScienceOpen disciplines: Obstetrics & Gynecology
                Keywords: abdominal ectopic pregnancy, hcg, laparoscope, ivf, case report

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