Background: Intramural pregnancy associated with adenomyosis after in vitro fertilization and embryo transfer is a rare occurrence.
Case: A 37-year-old woman presented with a history of 2 dilation and curettage procedures after 2 miscarriages in the first trimester. She underwent transvaginal ultrasound and systemic and sonography-guided local methotrexate injection.
Result: The woman was successfully treated, and her fertility was maintained with no complications from the procedure.
Conclusion: Early diagnosis of intramural pregnancy by skipped menstruation, elevated beta human chorionic gonadotropin (beta-hCG) and intramural cyst not connected the with the endometrium and with no other possible sites of ectopic pregnancy allows the clinician to plan the conservative treatment method at the optimum time, with more opportunity for conservation of fertility.