Laparoscopic management of consecutive ovarian pregnancy in a patient with infertility

Summary

The diagnosis of ovarian pregnancy is based on the improper rise of serum beta-hCG levels, sonographic findings of an empty uterus, highly characteristic ovarian formation with double hyperechogenic ring surrounding small hypoechogenic field, and the laparoscopic verification of Spiegelberg's criteria. We present a case of ovarian pregnancy in spontaneous cycle in 34-year-old woman following two unsuccessful IVF/ET procedures and ovarian pregnancy on contralateral side laparoscopically treated seven months ago, also achieved in non-stimulated, spontaneous cycle. On admission she had a serum hCG level of 596 mIU/mL on cycle day 46 and an empty uterus. Transvaginal sonography showed a 20 mm ring-like thick-walled hyperechogenic structure within the left ovary. The echogenic ring was surrounded by irregular, hypoechogenic structures suggestive of an ovarian pregnancy with periluteal hemorrhage and blood clots. The ruptured cystic ovarian pregnancy and the corpus luteum were removed by laparoscopy. During the procedure we have seen two clips on the right ovary placed laparoscopically to achieve hemostasis after rupture of the ovarian pregnancy seven months ago. Histopathology showed isolated chorionic villi within hemorrhagic areas in the vicinity of the corpus luteum.

Laparoskopisches Management aufeinanderfolgender Ovarialgravidität bei einer Patientin mit Fertilitätsstörungen

Zusammenfassung

Wir berichten den Fall einer 34jährigen Patientin mit Ovarialgravidität nach nicht-erfolgreicher IVF-Behandlung. Sieben Monate vorher war bei der Patientin auf der kontralateralen Seite ebenfalls eine Ovarialgravidität laparoskopisch behandelt worden.

MeSH

C13.703 pregnancy complications

Key words

Laparoscopy - ovarian pregnancy - infertility - IVF/ET - transvaginal sonography

Schlüsselwörter

Laparoskopie - Ovarialgravidität - Fertilitätsstörung - transvaginale Sonographie

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