A heterotopic pregnancy involves multiple embryos implanted in different locations, usually one in the uterus and another ectopically. This rare condition can pose significant risks to both the mother and the developing embryos. Heterotopic pregnancy is very rare. An interstitial heterotopic pregnancy is even rarer, representing 2%–4% of all ectopic pregnancies, but it has a much higher mortality rate overall because of the complexities involved in diagnosis and management. This case involves a rare instance of interstitial heterotopic pregnancy, likely resulting from assisted reproductive technology. Ultrasound revealed a live intrauterine pregnancy and an interstitial ectopic pregnancy sac. A 40-year-old woman, G5P1Ab1Ep2, was referred to the hospital triage in her 7th week of pregnancy due to abnormal ultrasound findings. Considering the clinical conditions and the possibility of uterine rupture with increasing gestational age, a decision was made to reduce the ectopic pregnancy by injecting KCl. Ultimately, a multidisciplinary approach involving obstetricians, gynecologists, and, when necessary, maternal–fetal medicine specialists is vital to optimize outcomes for both the mother and the developing fetus.

A 35 year-old woman at 7-week gestational age was referred to our hospital. The patient was diagnosed with the heterotopic interstitial pregnancy by transvaginal ultrasonography after receiving in vitro fertilization (IVF) and embryo transfer.Laparoscopic excision and curettage was successfully performed at 8.4-gestational age under general anesthesia and the patient was discharged 2 days after operation without any post-operative complications. The woman had normal antenatal follow-up and delivered a healthy baby at term by cesarean section.

Background: Interstitial Ectopic Pregnancy (IEP) is an uncommon type of ectopic pregnancy with the risk of rupturing and bleeding. The incidence of IEP is about 2-4% of all EPs. The diagnosis and management are challenging. We present a well-timed and managed case of IEP. Case: The case was a 37-yr-old woman presented at the Royan Institute with a chief complain of sudden onset of pelvic pain and moderate vaginal bleeding, three weeks after her positive pregnancy test. She had got pregnant with in-vitro fertilization procedure. She was admitted for a two-dimensional ultrasound (2DUS). The 2DUS findings showed a gestational sac with live embryo and yolk sac which was located high in the fundus and eccentric to the endometrium. The suspicion of IEP rose after the 2DUS findings, the confirmation of further diagnosis was then done by threedimensional ultrasound, and the treatment was done by laparoscopy. The patient underwent laparoscopic left corneal resection. She was discharged after two days and her β-hCG achieved complete resolution (< 5 mIU/mL) after two weeks’ follow-up. Conclusion: According to the life-threatening complications that are associated with IEP, acquaintance and suspicion about IEP is important. Specified information that obtained by three-dimensional ultrasound could be useful for exact locating and detection.