Objective: To report a case of a heterotopic primary abdominal pregnancy after two-blastocyst IVF-ET.
Design: Case report.
Setting: University-based IVF program.
Patient(s): A woman with a heterotopic abdominal pregnancy after IVF-ET.
Intervention(s): Pituitary down-regulation with luteal antagon, ovulation induction with menotropins, IVF-ET, progesterone in oil for luteal support, dilation and curettage for missed abortion, laparoscopy, and resection of abdominal gestation.
Main outcome measure(s): Human chorionic gonadotropin levels, pelvic ultrasound examinations, and laparoscopic and pathologic findings.
Result(s): A heterotopic abdominal pregnancy occurred after a two-blastocyst IVF-ET. The concurrent intrauterine gestation resulted in a miscarriage.
Conclusion(s): The number of embryos transferred has been identified as a powerful risk factor for heterotopic pregnancy; however, heterotopic pregnancy can occur following a two-embryo, blastocyst stage transfer.