Case Report Triplet Delivery following Unilateral Twin Salpingocyesis Johnson O. Komolafe, 1,2 Rasaq A. Akindele, 1 Adeniyi O. Fasanu, 1 Callistus A. Akinleye, 3 Taiwo O. Akinbile, 4 Monisayo O. Komolafe, 2,5 and Muyiwa O. Oguntunde 2 1 Department of Obstetrics & Gynaecology, College of Health Sciences, PMB 5000, Isale-Osun, Osogbo, Osun State, Nigeria 2 Ayomide Women’s Health Specialist Hospital, Osogbo, Osun State, Nigeria 3 Department of Community Medicine, College of Health Sciences, PMB 5000, Isale-Osun, Osogbo, Osun State, Nigeria 4 Department of Obstetrics & Gynaecology, Lautech Teaching Hospital, Osogbo, Nigeria 5 Renal Unit, Nursing Department, Lautech Teaching Hospital, Osogbo, Osun State, Nigeria Correspondence should be addressed to Johnson O. Komolafe; komosayo@gmail.com Received 7 December 2014; Revised 29 January 2015; Accepted 16 March 2015 Academic Editor: Cem Ficicioglu Copyright © 2015 Johnson O. Komolafe et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. We present the case of a 36-year-old woman with primary infertility of six-year duration who had IVF/ICSI on account of male factor infertility. Transvaginal scanning done on the 30th day following embryo transfer revealed an empty uterine cavity with two gestational sacs containing active fetal echoes in the right adnexum. Patient reluctantly had right salpingectomy via open laparatomy. he patient had repeat embryo transfer eleven months aterwards that culminated in the delivery of living twins with a fetal papyraceous. 1. Introduction Ectopic pregnancy (salpingocyesis) following IVF cycle is not a rare occurrence with a range from 1.46% to 4.9% [1, 2]. Heterotopic pregnancy in IVF treatment is not as common as salpingocyesis with an incidence of 0.3% to 1% [3]. Common documented risk factors for salpingocyesis are tubal factor infertility, previous ectopic pregnancy, previous surgery for endometriosis, and previous myomectomy [1, 3]. However, having double (twin) gestational sacs outside the regular uterus is not common. None has been recorded following natural conception to the best of our knowledge. We document the second case of twin ectopic gestation following IVF with a peculiar emotional challenge of refusal of treatment by a woman who had waited for six years to ever achieve any pregnancy. he initial set back, however, gave way to triplet intrauterine pregnancy leading to delivery of living twins. 2. Case Report he patient was a 36-year-old nullipara referred to our fertility unit by a gynaecologist on account of 6-year history of inability to achieve pregnancy. Details of assessment prior to referral were not made available but summary revealed primary infertility due to male factor infertility. She had ovulatory cycles; tubal factor was not investigated because of no apparent risk factor. She had undergone four failed intrauterine inseminations with husband semen. Assessment revealed that uterus was retroverted, and day 3 FSH value is airmed to be 9.9 I.U/L. Semen volume was 2.2 mLs, highly viscous with sperm concentration of 5 million/mL, total sperm number per ejaculate being 11 million, progressive motile sperm of 28%, and normal sperm forms of 11%. Based on duration of infertility with severe male factor couple was counseled for IVF-ICSI (in vitro fertilization with intracytoplasmic sperm injection cycle). She had a long protocol agonist cycle using daily buserelin injection and highly puriied FSH/LH (Menopur). Four grade 1 embryos (three 6-cell and one 4-cell) were transferred into the uterus on day 2 of embryo life using Wallace sot embryo transfer catheter. Introducer was used and embryo transfer time was approximately 4 minutes. Urine pregnancy test was positive on day 20 of embryo life. TVS done on day 33 of embryo life revealed uterus devoid Hindawi Publishing Corporation Case Reports in Obstetrics and Gynecology Volume 2015, Article ID 512845, 3 pages http://dx.doi.org/10.1155/2015/512845