Sugawara Nobuo, Sato Rie, Kato Mika, Manome Tomomi, Kimura Yasuyuki, Araki Yasuhisa, Araki Yasuyuki
Iwaki Women's Clinic Iwaki Japan.
The Institute for Advanced Reproductive Medical Technology Gunma Japan.
Reprod Med Biol. 2017 Oct 3;16(4):396-400. doi: 10.1002/rmb2.12053. eCollection 2017 Oct.
To present an extremely rare case of bilateral tubal pregnancies following a single-embryo transfer in a woman with a 4 year history of infertility prior to seeking assisted reproductive technology.
A pregnancy resulted from the transfer of an embryo that had been thawed from a frozen blastocyst during a hormone replacement cycle. An ultrasound that was performed at 5 weeks and 5 days of gestation revealed a gestational sac, embryo, and heartbeat in the right fallopian tube and similar signs of a gestational sac in the left fallopian tube. A laparoscopy revealed clear signs of an ectopic pregnancy in the ampulla of the right fallopian tube. Signs of swelling also were seen in the ampulla of the left fallopian tube. As the possibility of bilateral tubal pregnancies could not be ruled out, both fallopian tubes were removed. Pathological tests revealed chorionic villi and trophoblasts in both the left and right fallopian tubes.
All previously reported cases of bilateral tubal pregnancies have been a result of multiple ovulations or multiple-embryo transfer and no case of bilateral tubal pregnancies after a single-embryo transfer has ever been reported. No genetic testing was performed; thus, it cannot be definitively stated that the divided chorionic villi and trophoblasts came from only one embryo.
报告一例极为罕见的双侧输卵管妊娠病例，该患者在寻求辅助生殖技术前有4年不孕史，此次为单胚胎移植后发生双侧输卵管妊娠。
在激素替代周期中，移植一枚经冻融囊胚解冻后的胚胎后成功妊娠。妊娠5周5天时超声检查显示右侧输卵管有妊娠囊、胚胎及心跳，左侧输卵管也有类似妊娠囊的迹象。腹腔镜检查显示右侧输卵管壶腹部有明确的异位妊娠迹象，左侧输卵管壶腹部也可见肿胀迹象。由于不能排除双侧输卵管妊娠的可能性，遂将双侧输卵管切除。病理检查显示左右两侧输卵管均有绒毛膜绒毛和滋养层细胞。
既往报道的所有双侧输卵管妊娠病例均为多排卵或多胚胎移植所致，从未有单胚胎移植后发生双侧输卵管妊娠的病例报道。未进行基因检测，因此不能明确断定分离出的绒毛膜绒毛和滋养层细胞仅来自一个胚胎。
