HETEROTOPIC PREGNANCY AFTER OVULATION INDUCTION AND ASSISTED REPRODUCTIVE TECHNOLOGIES - A LITERATURE-REVIEW FROM 1971 TO 1993

Objective: To review and analyze records on heterotopic pregnancy occu rring after ovulation induction and assisted reproductive technologies . Data Identification: Case reports in the English literature related to the topic were identified through a computerized bibliography searc h up to December 1993. Conclusions: The incidence of heterotopic pregn ancies increased in recent years because of the escalating use of new reproductive technologies in infertile patients and has stabilized at approximately 1:100 pregnancies with these procedures. The main reason s for development of such a condition in these patients are past tubal or pelvic disease and multiple ovulations or multiple ET. Progress ha s been made in diagnosis of heterotopic pregnancy during the last two decades, mainly because of development of ultrasonographic techniques, especially transvaginal ultrasonography. Treatment of heterotopic pre gnancy should be prompt to avoid maternal morbidity and mortality from extensive intraperitoneal bleeding. No increased intrauterine fetal m ortality due to hemoperitoneum has been proven in the present review, except in advanced cornual pregnancies. More experience is needed for application of new treatment modalities such as salpingocentesis, whic h are used successfully for ectopic pregnancy, in treatment of heterot opic pregnancy. With early diagnosis and skillful treatment, the outco me of the intrauterine pregnancy is favorable and its survival rate sh ould increase in the future.