Heterotopic abdominal pregnancy following two-blastocyst embryo transfer.

Objective: To report a case of a heterotopic primary abdominal pregnancy after two-blastocyst IVF-ET.

Design: Case report.

Setting: University-based IVF program.

Patient(s): A woman with a heterotopic abdominal pregnancy after IVF-ET.

Intervention(s): Pituitary down-regulation with luteal antagon, ovulation induction with menotropins, IVF-ET, progesterone in oil for luteal support, dilation and curettage for missed abortion, laparoscopy, and resection of abdominal gestation.

Main Outcome Measure(s): Human chorionic gonadotropin levels, pelvic ultrasound examinations, and laparoscopic and pathologic findings.

Result(s): A heterotopic abdominal pregnancy occurred after a two-blastocyst IVF-ET. The concurrent intrauterine gestation resulted in a miscarriage.

Conclusion(s): The number of embryos transferred has been identified as a powerful risk factor for heterotopic pregnancy; however, heterotopic pregnancy can occur following a two-embryo, blastocyst stage transfer.