The Effect of IVF (in vitro fertilization) on Heterotopic Pregnancy: A Systematic Review Study
The Effect of IVF (in vitro fertilization) on Heterotopic Pregnancy: A Systematic Review Study
Elnaz Azadi,1Ali Ahmadi,2,*Dariush D. Farhud,3
1. MD. Student, Department of Medical Sciences, Kermanshah University of Medical Sciences, Qasr Shirin, Kermanshah, Iran 2. BSc. Student, Department of Biological Sciences and Technologies, Islamic Azad University Sari Branch, Sari, Iran 3. School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Introduction: Heterotopic pregnancy is a condition that occurs simultaneously in intrauterine and ectopic pregnancies. Ectopic pregnancy can occur in the ovaries, cervix, cornea, abdomen, or more commonly in the fallopian tubes. It is less common in the general population. It is from 1 in 30,000 and studies have shown that its incidence has increased in recent years. Reported heterotopic pregnancies often occur in women with a history of assisted reproductive techniques, ovarian stimulation, and pelvic inflammatory disease. As a result, heterotopic pregnancies increase to 0.1-2% in pregnancies using the methods. Reproductive assistance includes intrauterine insemination of semen and in vitro fertilization and embryo transfer with or without intra-cytoplasmic fertilization. Cervical pregnancy (CP) is a rare form of ectopic pregnancy (EP) in which the fetus implants and grows inside the endocervical canal. Heterotopic cervical pregnancy is an even rarer form of EP in which at least two embryos are implanted simultaneously in different locations and only one embryo is implanted in the uterine cavity. Although many treatment approaches are available, ideal management remains unclear. Here, we describe two cases of CP resulting from assisted reproductive technologies (ART). One case was fertilized by intracytoplasmic sperm injection (ICSI) for male factor infertility, and another was frozen-thawed embryo transfer (FET) followed by in vitro fertilization (IVF). This study aimed to evaluate the effect of IVF (in vitro fertilization) on heterotopic pregnancy
Methods: This is a secondary study (Systematic Review - 2022) looking for preferential reports for systematic reviews and meta-analysis recommendations (PRISMA) that we searched in the PubMed, Embase, and Ebsco databases for published studies on IVF and Heterotopic Pregnancy. There were no restrictions based on language, age, or country of origin. The first search was conducted on May 1, 2022, followed by an additional search on May 12, 2022. The three authors independently screened all search results from three databases at the title and abstract level, and if any, the discrepancies were resolved. We retrieved all available resources in the studies provided for additional resources. The following keywords were used to identify the reports, respectively: “IVF” [Mesh] AND “Heterotopic” [Mesh] OR “Pregnancy” [Mesh] OR “Cervical Pregnancy” [Mesh] “Ectopic Pregnancy” [Mesh] OR “intracytoplasmic sperm injection ”[Mesh]
Results: Rapid diagnosis of heterotopic pregnancy with no symptoms and the presence of a live intrauterine fetus is a challenge. Measurement of BHCG and a transvaginal ultrasound may aid in diagnosis Serial measurement of BHCG often complicates interpretation of Sacral uterine ligament (USL) Ectopic is abdominal. This is the first case of USL heterotopic pregnancy after in vitro fertilization (IVF). The patient presented 6 weeks after double embryo transfer with acute onset of abdominal pain and suspected ectopic pregnancy and was diagnosed with live tubes with live intrauterine pregnancy on ultrasound. Was removed. This highlights the importance of considering non-tubular heterotopic pregnancies in the context of risk factors, including IVF with double embryo transfer presented with abdominal pain. Transvaginal ultrasound is reduced. Therapies include surgery, expectant therapy, and fetal aspiration with or without the use of lethal drugs. Due to the rarity of heterotopic pregnancies, treatment experience is limited and it is difficult to determine which treatment is preferred. Fallopian tube closure, previous ectopic pregnancies, pelvic inflammatory disease, and previous surgery due to endometriosis or myomectomy are risk factors for heterotopic pregnancies. is.
Conclusion: Transvaginal ultrasound is the main diagnostic tool because the ectopic fetus is mostly located inside the wall of the fallopian tubes, fallopian tubes, or ovaries. Laparotomy or laparoscopy are the main treatment options with appropriate perinatal outcomes.