Heterotopic Pregnancy Secondary to in vitro Fertilization-Embryo Transfer: Risk Factors and Pregnancy Outcomes

Area of Science:

• Reproductive Medicine
• Gynecology
• Obstetrics

Background:

• The incidence of heterotopic pregnancy (HP) is increasing due to assisted reproduction technology (ART) and pelvic inflammatory disease.
• Risk factors and optimal management strategies for HP remain incompletely understood.

Purpose of the Study:

• To identify risk factors associated with heterotopic pregnancy (HP) following in vitro fertilization-embryo transfer (IVF-ET).
• To evaluate pregnancy outcomes in patients with HP who undergo surgical treatment.

Main Methods:

• A retrospective study comparing 29 patients with HP to 116 patients with intrauterine-only pregnancy (IUP) after IVF-ET.
• Analysis of patient histories, pregnancy outcomes, and surgical treatment parameters.

Main Results:

• Patients with HP had higher rates of previous ectopic pregnancies, multiple abortions (≥2), and tubal infertility as an indication for IVF.
• HP cases showed increased spontaneous abortion and preterm delivery rates, with lower live birth rates compared to IUP.
• Significant risk factors for HP included a history of multiple abortions, tubal infertility, previous ectopic pregnancies, and the number of embryos transferred.
• Surgical treatment success was associated with shorter operative times, smaller ectopic mass size, and tubal ampullary location.

Conclusions:

• A history of ectopic pregnancy, multiple abortions, tubal infertility, and multiple embryo transfers are significant risk factors for HP post-IVF-ET.
• Favorable reproductive prognosis after surgical management of HP is linked to shorter operative duration, smaller ectopic mass size, and ampullary location.