Laparoscopic management of a bilateral ovarian pregnancy after failed methotrexate treatment

Abstract

To date, there have been three reported cases of bilateral ovarian pregnancy including the case reported here. As infertility has increased, so has the use of assisted reproductive techniques and in turn, the incidence of rare forms of ectopic pregnancy. The authors report a 32-year-old woman who underwent in vitro fertilization and embryo transfer (IVF-ET) and was shown to have an ectopic pregnancy through pelvic ultrasonography and serum beta-human chorionic gonadotropin. She was unsuccessfully treated medically (methotrexate single dose injection) and an emergency laparoscopy was subsequently performed. The laparoscopic finding was that both fallopian tubes appeared normal but a bilateral ovarian pregnancy was confirmed. Resection of the ectopic tissue was performed. Of the published cases of bilateral ovarian pregnancy, this is the only case managed laparoscopically. This case is of clinical significance as preserving as much ovarian tissue as possible is key in preserving fertility and promoting a quick recovery.