SPONTANEOUS RESOLUTION OF ECTOPIC PREGNANCY IN A SURROGATE AFTER OOCYTE DONATION AND FROZEN EMBRYO-TRANSFER

A case of tubal pregnancy in a young and healthy woman participating i n a programme of in-vitro fertilization (IVF) gestational surrogacy is reported. The gestational surrogate was the 30 year old fertile siste r of a 25 year old patient affected by stage 1 ovarian cancer After ma ndatory oncological consultation, the donor was recommended to prospec tively undergo controlled ovarian hyperstimulation cycles for embryo b anking before being treated by total hysterectomy, Available embryos w ere cryopreserved and after adequate endometrial preparation using art ificial cycles of hormone replacement therapy, three thawed frozen emb ryos were transferred to the surrogate, At 17 days following embryo tr ansfer the surrogate was noted to have a negative beta-human chorionic gonadotrophin (HCG) serum concentration, All medication was suspended and a few days later normal menstrual bleeding occurred, After 2 week s, the beta-HCG concentrations, performed as part of routine follow-up evaluation, were showing signs of trophoblast activity (236 mIU/ml), Taking into account the stable condition of the patient, a decision wa s made to undertake expectant management, At 43 days after embryo tran sfer, a complete tubal abortion was apparently seen in the posterior c ul-de-sac by ultrasound associated with a subtle and short lasting pel vic pain, We stress that this ectopic gestation was able to maintain p rolonged viability in conditions of absent corpus luteum and exogenous steroid supplementation.