title: The Risk Factors and Pregnancy Outcomes of 48 Cases of Heterotopic Pregnancy from a Single Center.
abstract: The purpose of this study was to investigate risk factors that are associated with heterotopic pregnancy (HP) following in vitro fertilization (IVF)-embryo transfer (ET) and to demonstrate the outcomes of HP after the surgical treatment of ectopic pregnancies. Forty-eight patients from a single center, who were diagnosed with HP between 1998 and 2012 were included. All of the patients had received infertility treatments, such as Clomid with timed coitus (n = 1, 2.1%), superovulation with intrauterine insemination (n = 7, 14.6%), fresh non-donor IVF-ET (n = 33, 68.8%), and frozen-thawed cycles (n = 7, 14.6%). Eighty-four additional patients were randomly selected as controls from the IVF registry database. HP was diagnosed at 7.5 ± 1.2 weeks (range 5.4-10.3) gestational age. In six cases (12.5%), the diagnosis was made three weeks after the patients underwent treatment for abortion. There were significant differences in the history of ectopic pregnancy (22.5% vs. 3.6%, P = 0.002). There were no significant differences in either group between the rates of first trimester intrauterine fetal loss (15.0% vs. 13.1%) or live birth (80.0% vs. 84.1%) after the surgical treatment for ectopic pregnancy. The risk factors for HP include a history of ectopic pregnancy (OR 7.191 [1.591-32.513], P = 0.010), abortion (OR 3.948 [1.574-9.902], P = 0.003), and ovarian hyperstimulation syndrome (OHSS) (OR 10.773 [2.415-48.060], P = 0.002). In patients undergoing IVF-ET, history of ectopic pregnancy, abortion, and OHSS may be risk factors for HP as compared to the control group of other IVF patients. The surgical treatment of HP does not appear to affect the rates of first trimester fetal loss or live birth.
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea .
authors.forename: Ji Hyun
authors.identifier: 0000-0002-4935-4841
authors.initials: JH
authors.lastname: Jeon
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea .
authors.forename: Yu Im
authors.identifier: 0000-0001-6969-1362
authors.initials: YI
authors.lastname: Hwang
authors.affiliation: Department of Medical Statistics & Informatics, School of Medicine, Catholic University of Daegu, Daegu, Korea .
authors.forename: Im Hee
authors.identifier: 0000-0002-9136-2407
authors.initials: IH
authors.lastname: Shin
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea .
authors.forename: Chan Woo
authors.identifier: 0000-0002-2564-6292
authors.initials: CW
authors.lastname: Park
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea .
authors.forename: Kwang Moon
authors.identifier: 0000-0003-0703-2024
authors.initials: KM
authors.lastname: Yang
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea .
authors.forename: Hye Ok
authors.identifier: 0000-0002-3899-7710
authors.initials: HO
authors.lastname: Kim
mesh_terms: D000028:Abortion, Induced; D000328:Adult; D016208:Databases, Factual; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D005865:Gestational Age; D006801:Humans; D050498:Live Birth; D016017:Odds Ratio; D011247:Pregnancy; D011256:Pregnancy Outcome; D063192:Pregnancy, Heterotopic / Q000175:diagnosis* / Q000601:surgery; D012307:Risk Factors
keywords: Fertilization in Vitro; Pregnancy Outcome; Pregnancy, Ectopic; Pregnancy, Heterotopic; Pregnancy, Interstitial