Interstitial pregnancy after frozen embryo transfer in a woman with prior bilateral salpingectomy: A case report and literature review

Abstract

We describe a rare case of interstitial pregnancy following frozen embryo transfer in a woman with previous bilateral salpingectomy. The 33-year-old patient with a history of recurrent early pregnancy loss conceived after in vitro fertilization. Transvaginal ultrasound revealed a gestational sac with cardiac activity implanted in the interstitial portion of the left uterine cornua, surrounded by a thin myometrial mantle. Medical management with methotrexate was unsuccessful, and serum human chorionic gonadotropin levels continued to rise. The patient underwent laparoscopic cornual wedge resection using local infiltration, monopolar resection, and double-layer closure. The procedure was completed with minimal blood loss, an uneventful postoperative course, and preservation of uterine integrity and future fertility potential. The patient was discharged on the second postoperative day, and follow-up confirmed a steady decline in human chorionic gonadotropin levels. This case highlights that interstitial pregnancy may occur even after bilateral salpingectomy, underlining the importance of early ultrasound surveillance, timely surgical management, and preventive strategies such as complete cornual excision at salpingectomy and single embryo transfer to reduce risks and optimize reproductive outcomes.