Spontaneous Heterotopic Pregnancy After a Previous Ipsilateral Oophorectomy: A Case Report

Abstract

Heterotopic pregnancy occurs when there is coexisting intrauterine and ectopic pregnancies. The increased incidence of multiple pregnancy with ovulation induction and assisted reproductive technology (ART) increases the risk of both ectopic and heterotopic pregnancy. It has an incidence ranging from to 1:30,000 pregnancies of spontaneous conceptions to 1:100 to 1:500 with the use of assisted conception. It is a rare event with significant maternal morbidity and mortality due to misdiagnosis and late presentation especially following spontaneous conception where index of suspicion is very low. We present a very rare case of heterotopic pregnancy in a natural conception after a previous contralateral oophorectomy, who subsequently had salpingectomy with normal progression of the intra-uterine pregnancy till date. In conclusion, this case study reminds us of the importance of maintaining a high index of suspicion for heterotopic pregnancies even in spontaneous conceptions. The potential mechanisms and comprehensive management strategies enhances understanding and guides clinical practice.