[A case of bilateral tubal pregnancy after IVF - ET].

The authors describe a rare case of bilateral tubal pregnancy after IVF. The patient is with secondary infertility. The preceding diagnostic laparoscopy excluded the presence of tubal factor. The results of the spermogram show average to severe form of Oligoasthenozoospermia. Short protocol with GnRH-antagonist was performed and two embryos were transferred on the third day. On the 36th day after the embryo transfer the patient was hospitalized with abdominal pain in the right hypogastric region, clinical and ultrasound indications for hemoperitoneum. Urgent laparotomy was performed followed by salpingectomy dextra due to hemoperitoneum caused by tubal abortion. The examination of the left adnexa reveals uruptured tubal pregnancy in the isthmic part of the tube and the decision for salpingectomy sinistra was taken. Histological examinations confirmed the diagnosis of ectopic pregnancy in both tubes. The frequency of some rare forms and localizations of ectopic as well as heterotopic pregnancies increase after ART.

[A rare case of pregnancy combined with a large ovarian tumour].

AIM: Our aim was to demonstrate the diagnostic difficulties as well as the atypical clinical development of ovarian tumours in combination with pregnancy. MATERIAL AND METHODS: We present a rare case of large mucinous cystadenoma in 32-year old patient, who is 20 gestational weeks pregnant. Ultrasound examination and MRI were performed, which visualized a huge multilocular ovarian tumour formation with a small amount of ascites. RESULTS: We performed laparatomy adnexectomy which included the ovarian cyst, partial omentectomy and we took 4 samples of smears from the whole abdominal cavity, as well as ascites samples for cytology. The pregnancy was preserved. The histological examinations reported: mucinous cystadenoma without morphological data for malignant transformation. CONCLUSIONS: In our rare case the organ preserving operation was a completely sufficient surgical staging procedure.