Aoki Y, Kumakiri J, Itakura A, Kikuchi I, Takahashi N, Satoru T
Clin Exp Obstet Gynecol. 2017;44(3):489-491.
To report the life-threatening complication of a raptured heterotopic pregnancy occurring from thawed single embryo transfer.
A 33-year-old woman underwent in vitro fertilization (IVF) under a step-up regimen. After oocyte collection, blastocysts were frozen, and a single frozen-thawed blastocyst was then transferred according to the natural cycle. On day 17 after embryo transfer, an intrauterine pregnancy was confirmed. On day 28, she complained of sudden abdominal pain and ultrasonography revealed marked fluid retention in the peritoneal cavity. Emergency laparoscopy was performed, revealing hemoperitoneum and a ruptured interstitial heterotopic pregnancy (HP), which was then resected laparoscopically. Because sexual intercourse had occurred shortly before the transfer, a HP comprising a spontaneous pregnancy and a pregnancy achieved by assisted reproductive technology was assumed. The fetus in the uterus survived and was delivered.
In this case, however, despite the single embryo transfer during the natural-cycle frozen-thawed embryo transfer process, the risk of life-threatening complication as a HP as a consequence of spontaneous pregnancy after sexual intercourse remained.
报告解冻单胚胎移植后发生的危及生命的异位妊娠破裂并发症。
一名33岁女性在递增方案下接受体外受精（IVF）。卵母细胞采集后，囊胚被冷冻，然后根据自然周期移植单个冻融囊胚。胚胎移植后第17天，确认宫内妊娠。第28天，她主诉突发腹痛，超声检查显示腹腔内有大量积液。进行了急诊腹腔镜检查，发现腹腔积血和间质部异位妊娠（HP）破裂，随后通过腹腔镜进行了切除。由于移植前不久发生了性行为，推测该HP由自然妊娠和辅助生殖技术获得的妊娠组成。子宫内的胎儿存活并分娩。
然而，在本病例中，尽管在自然周期冻融胚胎移植过程中进行了单胚胎移植，但性交后自然妊娠导致作为HP的危及生命并发症的风险仍然存在。
