A case of ovarian pregnancy with uterine penetration after in vitro fertilization following myomectomy

Abstract

  We report a case of ovarian pregnancy with uterine penetration after in vitro fertilization following myomectomy. A 38-year-old woman underwent myomectomy about 1 year before the current pregnancy. On day 28 after in vitro fertilization and embryo transfer (IVF-ET), she was transferred to our hospital because of a suspicion of ectopic pregnancy. Transvaginal ultrasonography detected a mass inside her right ovary. Emergency laparoscopic surgery was performed. The adnexal adhesion was severe. After adhesiolysis, chorionic villi were found inside of the right ovary, and the endometrium was also taken from the same site. Penetration of the posterior uterine wall was confirmed and repaired. In addition, bilateral salpingectomy was performed. After the surgery, the defective part of the uterine endometrium and myometrium thinning were detected. Future pregnancy was considered high-risk of uterine rupture or ectopic pregnancy. Further repair of the thinning myometrium is needed before another pregnancy is permitted.