Should sexual intercourse be avoided during the embryo transfer cycle? Life-threatening ruptured heterotopic pregnancy after single thawed embryo transfer: case report and review of the literature

Aoki, Yumiko; Kumakiri, Jun; Itakura, Akiko; Kikuchi, Isao; Takahashi, Naoko; Takeda, Satoru

doi:10.12891/ceog3647.2017

Cited by 7 publications

(6 citation statements)

References 13 publications

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“…We performed a literature search in PubMed using the terms “single embryo transfer” and “heterotopic pregnancy” and found four cases of HP after SET [ 4 – 7 ]. Regardless of treatment or outcome, we registered reported data on the clinical presentation, risk factors, management and outcomes.…”

Section: Discussionmentioning

confidence: 99%

Heterotopic pregnancy after a single embryo transfer with successful perinatal outcome: case report and literature review

Chen,

2024

Contracept Reprod Med

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A heterotopic pregnancy is a rare and serious pathological pregnancy. In this paper, we report a rare case of heterotopic pregnancy and perform a literature review. A 30-year-old patient with a history of left adnexectomy presented with persistent lower abdominal pain and hemorrhagic shock after single embryo transfer. Emergency laparoscopic exploration revealed a ruptured mass in the right isthmus of the fallopian tube, for which right salpingectomy was performed. After anti-inflammatory treatment and fetal preservation, the intrauterine pregnancy progressed smoothly, and a healthy baby was delivered at 39 weeks gestation. In this case, the patient’s heterotopic pregnancy was possibly due to a natural pregnancy caused by sexual intercourse during treatment, so we recommend that sexual intercourse be avoided during transfer cycles.

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Section: Discussionmentioning

confidence: 99%

Heterotopic pregnancy after a single embryo transfer with successful perinatal outcome: case report and literature review

Chen,

2024

Contracept Reprod Med

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“…High-risk factors for heterotopic pregnancy (HP) include a history of unilateral or bilateral salpingectomy [ 11 , 13 , 16 , 18 , 23 , 24 , 28 , 29 , 30 ], EP [ 11 , 16 , 18 , 24 , 28 , 29 ], ovulation induction, and IVF-ET [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 18 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ]. Particularly, IVF-ET increases the occurrence of IP [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Successful Ultrasound-Guided Methotrexate Intervention in the Treatment of Heterotopic Interstitial Pregnancy: A Case Report and Literature Review

Tan

Chen

et al. 2023

JPM

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Purpose: This study aims to share the experience of minimally invasive ultrasound-guided methotrexate intervention in the treatment of heterotopic interstitial pregnancy (HIP) with good pregnancy outcomes, and to review the treatment, pregnancy outcomes, and impact on the future fertility of HIP patients. Methods: The paper describes the medical history, clinical manifestations, treatment history, and clinical prognosis of a 31-year-old woman with HIP, and reviews cases of HIP from 1992 to 2021 published in the PubMed database. Results: The patient was diagnosed with HIP by transvaginal ultrasound (TVUS) at 8 weeks after assisted reproductive technology. The interstitial gestational sac was inactivated by ultrasound-guided methotrexate injection. The intrauterine pregnancy was successfully delivered at 38 weeks of gestation. Twenty-five HIP cases in 24 studies published on PubMed from 1992 to 2021 were reviewed. Combined with our case, there were 26 cases in total. According to these studies, 84.6% (22/26) of these cases were conceived by in vitro fertilization embryo transfer, 57.7% (15/26) had tubal disorders, and 23.1% (6/26) had a history of ectopic pregnancy; 53.8% (14/26) of the patients presented with abdominal pain and 19.2% (5/26) had vaginal bleeding. All cases were confirmed by TVUS. In total, 76.9% (20/26) of intrauterine pregnancies had a good prognosis (surgery vs. ultrasound interventional therapy 1:1). All fetuses were born without abnormalities. Conclusions: The diagnosis and treatment of HIP remain challenging. Diagnosis mainly relies on TVUS. Interventional ultrasound therapy and surgery are equally safe and effective. Early treatment of concomitant heterotopic pregnancy is associated with high survival of the intrauterine pregnancy.

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“…Interestingly, sexual arousal has been shown to improve the motility of spermatozoa, although the detailed molecular mechanism is not clear [ 13 ]. Furthermore, studies revealed that patients with sexual intercourse without contraception had a higher incidence of the risk of life-threatening complication as a heterotopic pregnancy as a consequence of spontaneous pregnancy after sexual intercourse during their FET cycles [ 14 ]. At present, it remains unclear whether the beneficial effects of sexual intercourse on the endometrial receptivity and embryo implantation are due to the transportation of semen into the vagina or the sexual behavior itself.…”

Section: Introductionmentioning

confidence: 99%

Impact of sexual intercourse on frozen-thawed embryo transfer outcomes: a randomized controlled trial

Hou

Yuan

et al. 2023

Contracept Reprod Med

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Background Exposure of the female reproductive tract to either seminal plasma or fluid component of the ejaculate is beneficial to achieving successful embryo implantation and normal embryo development. But whether the “physical” component of sexual intercourse during the peri-transfer period have any influence on frozen-thawed embryo transfer (FET) pregnancy outcomes is not clear. Methods We conducted a randomized trial that included 223 patients undergoing in vitro fertilization (IVF) treatment at a university-affiliated reproductive center from 19 July 2018 to 24 February 2019. Enrolled patients undergoing IVF treatment were randomized either to engage sexual intercourse using the barrier contraception (Group A, n = 116) or to abstain (Group B, n = 107) one night before FET. The primary outcome was clinical pregnancy rate. Results Patients having intercourse had higher clinical pregnancy rate (51.72% vs. 37.07%, P = 0.045) and implantation rate (38.31% vs. 24.77%, P = 0.005) compared to those did not engage intercourse. However, there was no significant difference of the spontaneous abortion rate between two groups (11.67% 33 vs. 14.63%, P = 0.662). Conclusions Sexual intercourse before embryo transfer may improve the clinical pregnancy and implantation rates during FET cycles. However, it should be noted that patients choose only one time for sexual intercourse, that is, the night before embryo transfer. Trial registration The present study was registered at the Chinese Clinical Trial Registry (http://www.chictr.org.cn/, ChiCTR1800017209).

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Should sexual intercourse be avoided during the embryo transfer cycle? Life-threatening ruptured heterotopic pregnancy after single thawed embryo transfer: case report and review of the literature

Cited by 7 publications

References 13 publications

Heterotopic pregnancy after a single embryo transfer with successful perinatal outcome: case report and literature review

Heterotopic pregnancy after a single embryo transfer with successful perinatal outcome: case report and literature review

Successful Ultrasound-Guided Methotrexate Intervention in the Treatment of Heterotopic Interstitial Pregnancy: A Case Report and Literature Review

Impact of sexual intercourse on frozen-thawed embryo transfer outcomes: a randomized controlled trial

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