Related Experiment Video
Updated: Aug 5, 2026
Improved Hysteroscopic Resection of Endometrial Polyps Using 6-Fr Micro-Scissors and Forceps
Published on: August 2, 2024
A case series: thirty-three cases with heterotopic pregnancy after assisted reproductive technology
Xinyang Li1, Han Zhang1, Qi Xi1
1Department of Prenatal Diagnosis and Reproductive Medicine Center, The First Hospital of Jilin University, Jilin University, Changchun, China.
Objectives:
This study was designed to explore the impacts of clinical features, surgical timing, embryo transfer type, and ectopic pregnancy location on intrauterine pregnancy outcomes among heterotopic pregnancy patients, with the goal of offering evidence-based guidance for clinical management.
Methods:
A retrospective analysis was conducted on 33 patients with clinically diagnosed heterotopic pregnancy admitted to our center between June 2019 and September 2025.
Result:
This study included 33 patients with heterotopic pregnancy one conceived after ovulation induction and 32 via in vitro fertilization (IVF). Final follow-up data showed that 66.67% of patients attained viable ongoing intrauterine gestation or live birth; no fetal structural malformations were observed during the entire follow-up period. Sequential identification of an intrauterine gestational sac, embryo and fetal cardiac activity on ultrasound was associated with progressively higher odds of successful intrauterine pregnancy among patients with heterotopic pregnancy. All three sonographic markers predicted favorable pregnancy outcomes (all P < 0.001). Visualized fetal cardiac activity exhibited the strongest predictive value for sustained pregnancy and live birth (OR = 22.00, 95% CI 3.24-149.30, P < 0.001). No significant differences in pregnancy outcomes were observed between blastocyst (D5) and fresh embryo transfers compared with D3 cleavage-stage embryos (OR = 0.42, 95% CI 0.08-2.14, P = 0.412; OR = 0.67, 95% CI 0.05-8.91, P = 1.000, respectively). Cases with better intrauterine embryonic development had significantly higher odds of favorable pregnancy outcomes versus those with poorer intrauterine development (OR = 28.75, 95% CI 2.62-315.41, P = 0.003).
Conclusion:
Ultrasonic indicators reflecting the development of the intrauterine gestational sac, such as the timing of yolk sac and fetal heartbeat visualization, and crown-rump length, were significantly superior to those of the ectopic gestational sac, indicating a favorable prognosis for the intrauterine pregnancy.
