A heterotopic pregnancy is MOST likely to occur in which clinical context?
- A Spontaneous conception in a woman with unilateral tubal occlusion
- B Following in vitro fertilisation and embryo transfer with multiple embryos ✓
- C Following ovarian stimulation with clomiphene alone
- D In women with prior pelvic inflammatory disease without assisted reproduction
Correct answer: B. Following in vitro fertilisation and embryo transfer with multiple embryos
Explanation
Heterotopic pregnancy (simultaneous intrauterine and extrauterine pregnancies) has an incidence of approximately 1/30,000 in spontaneous conception but rises dramatically to approximately 1/100–1/500 in assisted reproductive technology (ART), particularly IVF with multiple embryo transfer. The increased incidence is due to transfer of supernumerary embryos that may migrate to the tube while another implants intrauterine. Prior PID and tubal disease are risk factors for ectopic pregnancy but the risk of heterotopic specifically is driven by ART.
Reference: Williams Obstetrics, 26th ed.
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Written and medically reviewed by the StethoPrep medical team.