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Ectopic pregnancies after assisted reproductive technologies

Marieta Iskilieva, Nadya Magunska, Emil Kovachev, Atanas Shterev


Introduction: One of the complications of assisted reproductive technologies (ART) is development of pregnancy beyond the endometrium of the uterine cavity - ectopic pregnancy (EP). There are different factors that influence the frequency of EPs after ART-. On the one hand, the characteristics of ovarian hyperstimulation, and on the other - women's age, hormonal status, history of previous pregnancy, etc.

Aim: This is a retrospective study, whose purpose is to examine and evaluate different  risk factors in women with EP after ART.

Materials and Methods: This is a retrospective study conducted between 01.2013 and 12.2017 at the Dr. Shterev Medical Complex, Sofia. We have analyzed 5229 cycles - 3773 IVF/ICSI cycles, 875 FrET cycles, and 581 cycles with egg donation. A total of 1712 clinical, intrauterine, ectopic and heterotopic pregnancies after ART were included in our study.

Results and Discussion: The rate of EPs after ART in our group was 2.4%, which corresponds to previous data, published in the scientific literature. We have also identified some rare forms of EP - cornual and cervical pregnancy. The analysis we conducted showed that probable risk factors for EP are tubal infertility and associated chronic inflammatory processes of the fallopian tubes, increased number of transferred embryos, use of additional techniques - assisted hatching, polycystic ovary syndrome (PCOS), and previous surgery in the pelvis.

Conclusion: EP is a global medical emergency and its incidence increases following treatment of infertility. Early diagnosis and prompt intervention are crucial in order to diminish the morbidity and mortality, and to avoid complications thereafter.


ectopic pregnancy, ART, risk factors

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About The Authors

Marieta Iskilieva
SAGBAL Dr. Shterev Hospital, Sofia

Nadya Magunska
SAGBAL Dr. Shterev Hospital, Sofia

Emil Kovachev
Medical University of Varna

Department of Obstetrics and Gynecology, Faculty of Medicine

Atanas Shterev
SAGBAL Dr.Shterev Hospital Sofia

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