A case of heterotopic pregnancy with selective reduction of the ovum cervical localization and preservation of intrauterine pregnancy

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Failure of implantation with the formation of heterotopic pregnancy is, unfortunately, continues to accompany the IVF. This may be due to the inability of the impact on endometrial receptivity. Changing characteristics of endometrial receptivity in conducting IVF determines the probability of formation of this kind of complications. The lack of standards for the conduct of heterotopic uterine and cervical pregnancy include the woman to the group at high risk for bleeding, a subsequent hysterectomy and loss of fertility. Promptly detection of ectopic localization of the ovum by means of methods of ultrasonic diagnostics allows in some cases to carry out organ-sparing surgery. Currently, there is a need for improved approaches to preimplantation training. The article describes a clinical case of heterotopic pregnancy with successful selective reduction of cervical localization of one of the two fertilized eggs and preservation of intrauterine pregnancy.

Mariya L. Romanova

Author for correspondence.
I.P. Pavlov First St Petersburg State Medical University
Russian Federation, Saint Petersburg

MC, department of obstetrics, gynecology and reproductology

Igor M. Nesterov

I.P. Pavlov First St Petersburg State Medical University
Russian Federation, Saint Petersburg

MC, Assoc. Prof. of department of obstetrics, gynecology and reproductology

Aleksandr V. Dyachuk

Clinical hospital No 122 n.a. L.G. Sokolov of FMBA
Russian Federation, Saint Petersburg

DM, professor, Head of the Department of gynecology

Vladislav V. Chirskiy

Clinical hospital No 122 n.a. L.G. Sokolov of FMBA
Russian Federation, Saint Petersburg


  • Боярский К.Ю., Гайдуков С.Н., Пальченко Н.А. Современный взгляд на проблему рецептивности и тонкого эндометрия в программах ВРТ // Проблемы репродукции. – 2013. – № 4. – С. 51–60. [Boyarskii KYu, Gaidukov SN, Pal’chenko NA. Sovremennyi vzglyad na problemu retseptivnosti i tonkogo endometriya v programmakh VRT. Problemy reproduktsii. 2013;(4):51-60. (In Russ.)]
  • Alammari R, Thibodeau R, Harmanli O. Vaginal Hysterectomy for Treatment of Cervical Ectopic Pregnancy. Obstet Gynecol. 2017;129(1):63-5. doi: 10.1097/AOG.0000000000001782.
  • Boomsma CM, Kavelaars A, Eijkemans MJ, et al. Endometrial secretion analysis identifies a cytokine profile predictive of pregnancy in IVF. Hum Reprod. 2009;24:1427-35. doi: 10.1093/humrep/dep011.
  • Edwards RG. Human implantation: the last barrier in assisted reproduction technologies? Reprod Biomed Online. 2006;13:887-904. doi: 10.1016/s1472-6483(10)61039-5.
  • Macklon NS, Geraedts JP, Fauser BC. Conception to ongoing pregnancy: the “black box” of early pregnancy loss. Hum Reprod Update. 2002;8:333-43. doi: 10.1093/humupd/8.4.333.
  • Крылова Ю.С., Кветной И.М., Айламазян Э.К. Рецептивность эндометрия: молекулярные механизмы регуляции имплантации // Журнал акушерства и женских болезней. – 2013. – Т. 12. – № 2. – С. 63–74. [Krylova YS, Kvetnoy IM, Aylamazyan EK. Endometrial receptivity: the molecularmechanisms regulation of implantation. Journal of Obstetrics and Women’s Diseases. 2013;12(2):63-74. (In Russ.)]
  • Soares SR, Velasco JA. Fernandez M, et al. Clinical factors affecting endometrial receptiveness in oocyte donation cycles. Fertil Steril. 2008;89:491-501. doi: 10.1016/j.fertnstert.2008.01.080.
  • Адамян Л.В., Чернова И.С., Козаченко А.В. Комбинированное лечение шеечной беременности // Акушерство и гинекология. – 2012. – № 4–2. – С. 103–108. [Adamyan LV, Chernova IS, Kozachenko AV. Combination treatment in women with cervical pregnancy. Obstetrics and Gynecology. 2012;(4-2):103-8. (In Russ.)]
  • Орлов В.И., Линде В.А., Дубровина С.О., и др. Консервативное лечение шеечной беременности // Проблемы репродукции. – 2011. – Т. 17. – № 2. – С. 39–42. [Orlov VI, Linde VA, Dubrovina SO, et al. Сonservative management of cervical pregnancy. Problemy reproduktsii. 2011;17(2):39-42. (In Russ.)]
  • Frates MC, Benson CB, Doubilet PM, et al. Cervical ectopic pregnancy: results of conservative treatment. Radiology. 1994;191:773-5. doi: 10.1148/radiology.191.3.8184062.
  • Leeman L, Wendland C. Cervical ectopic pregnancy: diagnosis with endovaginal ultrasound examination and successful treatment with methotrexate. Arch Fam Med. 2000;9:72-7. doi: 10.1001/archfami.9.1.72.
  • Lessey BA. Assessment of endometrial receptivity. Fertil Steril. 2011;96(3):522-9. doi: 10.1016/J.fertnstert.2011.07.1095.
  • Paulson RJ. Hormonal induction of endometrial receptivity. Fertil Steril. 2011;96:530-5. doi: 10.1016/J.fertnstert.2011.07.1097.
  • De Geyter C, Schmitter M, De Geyter M, et al. Prospective evaluation of the ultrasound appearance of the endometrium in a cohort of 1,186 infertile women. Fertil Steril. 2000;73:106-13. doi: 10.1016/s0015-0282(99)00484-7.
  • Garcia-Velasco JA, Isaza V, Caligara C, et al. Factors that determine discordant outcome from shared oocytes. Fertil Steril. 2003;80:54-60. doi: 10.1016/s0015-0282(03)00545-4.
  • Berlanga O, Bradshaw HB, Vilella-Mitjana F, et al. How endometrial secretomics can help in predicting implantation. Placenta. 2011;32(3):271-5. doi: 10.1016/j.placenta.2011.06.002.
  • Zhang X, Chen CH, Confino E, et al. Increased endometrial thickness is associated with improved treatment outcome for selected patients undergoing in vitro fertilization-embryo transfer. Fertil Steril. 2005;83:336-40. doi: 10.1016/J.fertnstert.2004.09.020.


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