An unexpected quadruplet heterotopic pregnancy after bilateral salpingectomy and replacement of three embryos.

OBJECTIVE

To report a case of combined intrauterine and interstitial twin pregnancies after bilateral salpingectomy and IVF with replacement of three embryos.

DESIGN

Case report.

SETTING

University hospital.

PATIENT(S): A 31-year-old woman known to have bilateral salpingectomy for ectopic pregnancies who underwent IVF.

INTERVENTION(S): Laparotomy.

MAIN OUTCOME MEASURE(S): Postoperation intrauterine monozygotic twins survival and birth.

RESULT(S): After removing the interstitial monozygotic twin pregnancy, the patient had an uneventful postoperative course and delivered two healthy girls by cesarean section at 38 weeks' gestation.

CONCLUSION(S): Heterotopic pregnancy can still occur in women treated by IVF after bilateral salpingectomy. The early sonography follow-up of IVF pregnancy would be of value because of the reported higher incidence of pathological pregnancies and especially monozygotic twinning.