Ovarian pregnancy after an IVF program in a patient with reduced endometrial receptivity

Knyazeva E.A., Alieva K.U., Kalinina E.A.

National Medical Research Center of Obstetrics, Gynecology, and Perinatology Academician named after V.I. Kulakov, Ministry of Health of Russia, Moscow 117997, Ac. Oparina str. 4, Russia
Background. Despite significant achievements in the diagnosis and treatment of various gynecological diseases, the problem of extrauterine (ectopic) pregnancy remains relevant. Today ectopic pregnancy occupies one of the leading places in the structure of maternal mortality because it is very often accompanied by massive intraabdominal bleeding. The incidence of ectopic pregnancy is known to increase after assisted reproductive technology (ART) programs. This is facilitated by a number of the features that are characteristic of ART programs and absent in natural conception. In addition, impaired endometrial receptivity (including that due to disturbed methylation of a number of HOX family genes, etc.) may be a risk factor for ectopic pregnancy.
Description. The paper describes the clinical case of a 35-year-old female patient who applied to an IVF program because of primary male factor infertility and reduced endometrial receptivity. The IVF/ICSI program with embryo transfer (ET) in the stimulation cycle resulted in ectopic (ovarian) pregnancy.
Conclusion. In addition to the traditional list of necessary analyses and diagnostic tests, it is recommended that evaluation of endometrial receptivity (including HOXA10 and HOXA11 gene methylation) should be included in a comprehensive examination of women before the IVF program, especially women with failed IVF attempts in their histories and/or with recurrent miscarriage.

Keywords

IVF
infertility
ectopic pregnancy
endometrial receptivity
implantation window
DNA methylation
HOX genes
HOXA10
HOXA 11

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Received 08.12.2017

Accepted 22.12.2017

About the Authors

Knyazeva, Ekaterina A., post-graduate student of B.V. Leonov Department of Auxiliary Technologies in Infertility Treatment, National Medical Research
Center of Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov of Ministry of Health of Russia.
117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954382501. E-mail: knyazeva.ea@gmail.com
Alieva, Kamila U., PhD, Researcher of B.V. Leonov Department of Auxiliary Technologies in Infertility Treatment, National Medical Research Center of Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov of Ministry of Health of Russia.
117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954381341. E-mail: kaya79@mail.ru
Kalinina, Elena A., MD, The chief of B.V. Leonov Department of Auxiliary Technologies in Infertility Treatment, National Medical Research Center of Obstetrics,
Gynecology and Perinatology named after Academician V.I. Kulakov of Ministry of Health of Russia.
117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954381341. E-mail: e_kalinina@oparina4.ru

For citations: Knyazeva E.A., Alieva K.U., Kalinina E.A. Ovarian pregnancy after an IVF program in a patient with reduced endometrial receptivity. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (8): 180-4. (in Russian)
https://dx.doi.org/10.18565/aig.2018.8.180-184

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