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Tubal pregnancy associated with additional conception in a contralateral tube
Author(s) -
Ishikawa Hiroshi,
Kiyokawa Takako,
Okayama Jun,
Usui Hirokazu,
Shozu Makio
Publication year - 2015
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.12744
Subject(s) - hydrosalpinx , medicine , pregnancy , salpingectomy , ectopic pregnancy , fallopian tube , human chorionic gonadotropin , obstetrics , in vitro fertilisation , gynecology , infertility , hormone , genetics , biology
Pregnancy of unknown location is defined as empty endometrial cavity despite positive pregnancy test, and often develops as overt intrauterine or ectopic pregnancy. The pathophysiology of persistent pregnancy of unknown location, however, which involves continuous low serum human chorionic gonadotropin without any visible implantation site, is unknown. We report a case of left tubal pregnancy associated with additional conception in the contralateral tube. Left tubal pregnancy was suspected in a 40‐year‐old nulligravid woman after two embryo transfers following in vitro fertilization. Laparoscopic bilateral salpingectomy was performed for bilateral hydrosalpinx. Products from an additional conception were identified in the right tube. Short tandem repeat analysis using genomic DNA from resected specimens indicated two conceptions of different origin. The extra conception identified on microscopy may indicate one pathogenesis of persistent pregnancy of unknown location. Salpingectomy of the contralateral tube with hydrosalpinx is an option to prevent persistent occult pregnancy.