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Ectopic pregnancy after assisted reproductive technology: a retrospective study

Emil Kovachev, S. Ivanov, A. Abbud, A. Tsonev


In this study from 2006 to 2010,1628 IVF-ET cycles were performed in our unit. Long protocol with GnRH agonist plus recombinant FSH, short protocol with GnRH antagonist, short protocol with microdoses of GnRH agonist (flare up), natural modified cycle with GnRH antagonist and hCG were applied. The serum level of the P-hCG was measured 12 days after embryotransfer (ET). When positive, the P-hCG level was determined every 4 days until the ultrasound examination 22 days after the ET. From 1628 IVF - ET cycles, we had 10 tubal pregnancies (0,61%) and one heterotopic pregnancy (HP). Salpingectomy was performed in all patients, 7 had laparoscopy, and 3 underwent emergent laparotomy due to hemorrhagic shock. Regarding the HP patient, an ultrasound scan confirmed a viable intrauterine 8-weeks gestation and an ectopic pregnancy (EP) in the left tube with fetal heartbeat corresponding to gestational age of 7-8 weeks. Laparoscopy with left salpingectomy was performed the following day. The intrauterine pregnancy proceeded uneventfully. The patient delivered by elective Cesarean section at 39 weeks of gestation due to breech presentation. Patients undergoing IVF-ET must be informed of the risk of EP and the possibility of HP should not be ignored.


IVF, ectopic pregnancy, heterotopic pregnancy

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About The Authors

Emil Kovachev
Medical University of Varna

Department of Obstetrics and Gynecology, Faculty of Medicine;

Medical Centre of Assisted Reproduction "Varna"LTD, Varna

S. Ivanov
Medical University of Varna

Department of Obstetrics and Gynecology, Faculty of Medicine

A. Abbud
Medical University of Varna

Department of Obstetrics and Gynecology, Faculty of Medicine

A. Tsonev
Medical University of Varna

Department of Obstetrics and Gynecology, Faculty of Medicine

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