A Case of Bilateral Ectopic Pregnancy Following Intra-Uterine Insemination

Abstract

We describe a case of a 31-year-old lady with primary subfertility who conceived only after her third intra-uterine insemination. She was diagnosed to have a right ectopic pregnancy which failed methotrexate treatment. Diagnostic laparoscopy confirmed bilateral ectopic pregnancies. A review was conducted for any consensus reached on diagnosis and optimal management of bilateral ectopic pregnancies after artificial reproductive techniques (ARTs). A search on Pubmed was carried out for publications in peer-reviewed journals with the following keywords: bilateral tubal ectopic pregnancy, heterotopic. Ten suitable publications were retrieved. Bilateral tubal ectopic pregnancy is rare, often missed on radiology and an unexpected finding at surgery. There should be a high index of suspicion for bilateral ectopic pregnancies after ART. Poor correlation with B-hCG levels further confuses diagnostic accuracy. It is prudent to ensure accurate diagnosis of bilateral ectopic pregnancies and appropriate intervention to reduce morbidity and mortality. Salpingostomy should be considered in patients with subfertility to preserve the possibility of future pregnancies.