Ovarian pregnancy; relationship to an intrauterine device.

ABSTRACT

PIP: The etiology of primary ovarian pregnancy is unknown, although an IUD is frequently implicated. This paper presents two cases of primary ovarian pregnancy diagnosed at Dokuz Eylul University in Izmir, Turkey, in 1995 and discusses the pathogenesis in relation to the IUD. In the first case, the woman had used a copper-releasing IUD for 3 years and had had it removed 1 month before presentation. The second woman had been using a Lippes Loop device for 16 years. Ovarian pregnancy was diagnosed only after pathologic examination of the specimen. Both pregnancies were located within the corpus luteum, suggesting that fertilization and nidation occurred at the ovulation site. Although the IUD protects against ectopic pregnancy in the first 24 months of use, the risk increases over time as the reversible foreign-body histologic changes associated with IUD use become established in the Fallopian tube. The preoperative diagnosis of primary ovarian pregnancy is very difficult. It should be kept in mind, however, that ovarian pregnancy is more frequent in ectopic pregnancies associated with IUD use.