Heterotopic Pregnancy after Assisted Reproductive Techniques

Heterotopic pregnancy (HP) is the simultaneous occurrence of intra- and extrauterine pregnancies. It is a rare event in spontaneous pregnancies with an incidence of less than 1:15000 however the frequency has increased to 1% in accordance with the widespread use of assisted reproductive techniques (ART). The pre-operative diagnosis of this condition is generally difficult and it would be life threatening for mother and the intrauterine pregnancy. In this report we present three cases of HP following ART. All cases underwent a standard long protocol and embryo transfers (ET) were performed 48 hours after oocyte retrievals. Finally two viable intrauterine gestations ended in miscarriages and the third resulted in the delivery of a healthy infant. The possibility of a heterotopic pregnancy following tubal pathologies endometriosis and pelvic adhesions should be considered by gynecologists during IVF procedures. Moreover by implantation of a single embryo the incidence of this risky condition will be dramatically reduced.