Repeated ectopic pregnancy after ICSI therapy and embryo transfer - A case report and literature review

The risk of ectopic pregnancy is increased following IVF/ICSI embryo transfer treatment. Established risk factors include the number of embryos transferred, length of the uterine cavity, fluid volume and the extent of tubal damage in cases of tubal sterility. Hence, ectopic pregnancies following IVF treatment are more common than after ICSI treatment. We report a rare case of two consecutive ectopic pregnancies in one patient following ICSI treatment. Since pathology of the fallopian tubes could be excluded, a risk factor for the development of an ectopic pregnancy seems to be a difficult embryo transfer with a consecutive arousal of uterine contractions mainly in cervico-fundal direction which might have lead to an expulsion of embryos into the fallopian tubes. To avoid a further ectopic pregnancy in forthcoming cycles we performed bilateral complete salpingectomy during laparoscopy in that patient.