Cervical pregnancy after in vitro fertilization: possibilities of organ-preserving treatment technologies

Abstract. Objective: this paper presents a clinical case of successful treatment of a patient with a cervical pregnancy (CP) after in vitro fertilization using organ-preserving technologies. Case report. This paper presents the case report of a 36-year-old female patient admitted to a gynecological hospital with a diagnosis of progressive CP induced by in vitro fertilization (IVF) using intracytoplasmic sperm injection (ICSI). The patient's complaints, medical history, and general physical and genital parameters are presented in detail. The dynamics of pelvic ultrasound (US) results with color Doppler mapping (CDM) and laboratory parameters, including serum β-hCG levels, are presented. The examination resulted in the following clinical diagnosis «Progressive CP of 6 weeks, induced by IVF + ICSI. Primary infertility of tubal origin. Chronic endometritis». A decision was made to perform vascular selective uterine artery embolization (UAE), followed by monitoring serum β-hCG levels and ultrasound data over time. On the fifth day after UAE, the fertilized egg was removed under cervicoscopy, and the implantation site was electrocoagulated using a hysteroresectoscope. Total blood loss was 10 ml. The products of conception were sent for histological examination, which confirmed the clinical diagnosis. After a follow-up ultrasound and determination of serum β-hCG levels on the eighth day, the patient was discharged to the outpatient clinic in satisfactory condition under the supervision of a gynaecologist. The specific features of this clinical observation are: the occurrence of CP after the use of assisted reproductive technologies (ART), timely diagnosis, and the successful use of modern treatment technologies (UAE and hysteroresectoscopy), which allow the preservation of the woman's reproductive function.

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