Abstract
INTRODUCTION AND IMPORTANCE: Heterotopic pregnancy (HP), defined as the coexistence of intrauterine and ectopic pregnancies, is a rare occurrence following natural conception or assisted reproductive technology (ART) procedures. Diagnosing HP can be challenging due to its rarity and often asymptomatic presentation. CASE PRESENTATION: We present a case of HP in a woman with unexplained infertility who underwent in vitro fertilization-embryo transfer (IVF-ET). The HP involved an intrauterine pregnancy and a tubal-ovarian pregnancy (OP), which was diagnosed through combined sonography and managed conservatively via laparoscopy. CLINICAL DISCUSSION: The incidence of HP is rare, with reported incidences ranging from 1 in 10,000 to 1 in 50,000 naturally conceived pregnancies. Early detection of HP after ART is crucial for preserving intrauterine pregnancies and fertility potential, highlighting the importance of improved sonography imaging techniques. CONCLUSION: This case underscores the importance of vigilant monitoring for gynecologists treating IVF patients, not only regarding intrauterine pregnancies but also pregnancies of unknown location. Early and regular ultrasound monitoring, along with expertise in sonography, is essential for accurate diagnosis.