A Case of Ruptured Ovarian Ectopic After Embryo Transfer With Low Serum hCG and Fertility Conserving Laparoscopy

Abstract

Ovarian pregnancy is a rare form of ectopic pregnancy that remains a diagnostic enigma. We report a 39-year-old nulliparous female undergoing in vitro fertilization (IVF) and presenting with severe abdominal pain to a hospital after embryo transfer. Serum beta-hCG after embryo transfer was low at 5.4 IU/L. Repeated serum beta-hCG in the hospital was elevated at 1,528 IU/L. Transabdominal ultrasound revealed a 9.8 cm complex mass in the midline in the pouch of Douglas. No intrauterine gestational sac was seen. She underwent emergency diagnostic laparoscopy revealing a small 2 2 cm ruptured right ovarian ectopic pregnancy with active hemorrhage seen. A wedge resection of the right ovarian ectopic was performed and hemoperitoneum was drained. Ovarian tissue sent for histopathology confirmed the diagnosis of a ruptured ovarian ectopic. Post-operative hCG level was negative after follow-up. Consequently, the patient was treated successfully with fertility-conserving laparoscopy.




J Med Cases. 2016;7(4):150-152
doi: https://doi.org/10.14740/jmc2464w