체외수정 - 배아이식 시술후 발생한 양측 난관임신 1 예 = Simultaneous bilateral tubal pregnancies following in - vitro fertilization and embryo transfer

국문 초록 (Abstract)

양측 난관 임신은 두 개의 배아가 난관에 착상하는 아주 드문 자궁외임신중의 하나이며 그 빈도는 1:725∼1:1580이다. 최근에는 보조생식술(ART)의 적용 증가로 인해 발생의 예가 증가하고 있으며, 그 가능성을 염두에 두지 않은한 임상적 진단이 어려우므로 다른 부위의 자궁외임신보다 훨씬 큰 위험성에 노출되어 있다.
저자등은 33세의 여자환자에서 체외수정 및 배아이식술후 발생한 양측난관임신 1예를 체험 하였기에 문헌 고찰과 함께 이를 보고하는 바이다.

다국어 초록 (Multilingual Abstract)

Over the last 20 years, the frequency of multiple pregnancy has increased mainly because of the introduction of exogenous pituitary gonadotropins in the treatment of infertility. Since the advent of assisted reproductive technology, the concern about ectopic implantation of embryos has increased dramatically and it continues to be a major complication of in vitro fertilization and embryo transfer (IVF-ET).
Bilateral tubal pregnancy is the least common type of ectopic implantation of two embryos. Of all extrauterine pregnancies, 1:725∼1:1580 are bilateral1,2. Simultaneous tubal pregnancies have been reported in natural cycles, recently, after ovulation induction, in-vitro fertilization2,3. The high incidence of ectopic pregnancy associated with IVF-ET continues to be a problem and frequencies of between 2.4 and 12.4% have been only a few reports of simultaneous bilateral tubal pregnancies following IVF-ET4.
This paper describes a case of a simultaneous bilateral tubal pregnancy after IVF-ET in a 33 year old patient. The diagnosis was confirmed by diagnostic laparoscopy performed 25 days after embryo transfer(sixth week of gestation), which revealed bilateral tubal pregnancy. Bilateral salpingectomy was performed. With a review of the literature on this topic, diagnostic aspects and treatment options are discussed.