Successful Live Births after Laparoscopic Management of Heterotypic Pregnancies in Assisted Reproductive Technology Cycles: A Tertiary Fertility Center Experience

Abstract

Background: To review and analyze the incidence of heterotypic pregnancies after intracytoplasmic sperm injection (ICSI) and embryo transfer and to report pregnancy outcome after successful management of heterotypic pregnancies. Setting: Nadkarni’s 21st Century Hospitals and Test Tube Baby Center, Surat, Gujarat, India. Design: Retrospective study. Materials and methods: Retrospective data were taken from hospital records from January 2013 to December 2015. A total of 2,771 patients underwent in vitro fertilization IVF/ICSI, out of which 1,455 patients were pregnant (52.5%). Out of the pregnant patients, the incidence of ectopic (EP) and heterotypic pregnancies was calculated. The etiological factors, management of heterotypic pregnancies, and their pregnancy outcome were reported. Conclusion: Out of the 1,455 pregnant patients, there were 29 EPs (EPs: 1.99%) and 5 were heterotypic (0.34%). Laparoscopic intervention was done for all five of them and successful pregnancy outcome was reported in terms of live birth. Clinical significance: Heterotypic pregnancy is rare and poses a diagnostic dilemma in assisted reproductive technology (ART) cycles. Serial beta-human chorionic gonadotropin (hCG) measurement is not reliable and ultrasonography may not confirm due to the presence of ovarian hyperstimulation syndrome (OHSS) or multiple cysts. Early diagnosis is ideal and good perinatal outcome can be achieved by prompt and excellent laparoscopic management of the heterotypic pregnancies.