Heterotopic pregnancies in an in-vitro fertilization program.

During a four-year period in vitro fertilization (IVF) was carried out in 2,356 cycles. The pregnancy rate per transfer was 24% while the incidence of ectopic pregnancies was 7.5% per pregnancy. There were seven cases of heterotopic pregnancies-simultaneous intra- and extrauterine pregnancies (1.5% among all IVF pregnancies). Two of them were diagnosed after tubal rupture of the ectopic pregnancy and five cases were diagnosed by ultrasound at the 7th or 8th week of gestation. Laparotomy and subsequent salpingectomy was carried out in six cases while in one case the ectopic pregnancy was removed by laparoscopy. Three out of the seven heterotopic pregnancies (43%) were successfully continued with normal intrauterine embryo development and delivery.