• Ho-Yen Chueh, Po-Jen Cheng, Chia-Wei Wang, Sheng-Wen Shaw, Chyi-Long Lee, and Yung-Kuei Soong.
• Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, Republic of China.
• Fertil. Steril. 2008 Nov 1; 90 (5): 2009.e19-21.

ObjectiveTo present two cases of ectopic twin pregnancy in a Cesarean section scar following IVF-embryo transfer.DesignCase report.SettingTertiary referral case center.Patient(S)Two women who had ectopic twin pregnancy in a Cesarean section scar, in both cases following IVF and embryo transfer.Intervention(S)Three-dimensional power Doppler ultrasound and diagnostic hysteroscopy were performed for early recognition and treatment.Main Outcome Measure(S)Prevention of pregnancy complications such as hemorrhage, uterine rupture, and preservation of fertility.Result(S)Case 1: diagnosis was made in a 31-year-old woman after IVF; she was managed with laparotomy excision of the twin pregnancy. Case 2: an early such pregnancy was diagnosed in a 37-year-old woman following IVF. She was treated successfully with hysteroscopy and laparoscopic surgery.Conclusion(S)Because ectopic pregnancy in a Cesarean scar carries high risk of uterine rupture and uncontrollable hemorrhage, such a twin pregnancy presumably carries similar risks. Focused application of high-resolution ultrasound and diagnostic hysteroscopy may help lead to early recognition of ectopic twin pregnancy in a Cesarean scar and prevention of complications such as hemorrhage and uterine rupture.

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