Ectopic Pregnancy and Assisted Reproductive Technologies: A Systematic Review

Ectopic pregnancy represents a rare pregnancy complication. In the last 20 years, with the use of IVF, heterotopic pregnancies have become more frequent, while this percentage differs between IVF programs. Many factors contribute to this, like the active management of hydrosalpinx or treatment of Chlamydia infection before starting a cycle. Although, in vitro fertilization is an expensive treatment, ectopic complication adds to this cost. Not a lot of studies exist for ectopic pregnancy after IVF. Most of them are case reports. Not a standard way exists, for dealing with heterotopic pregnancies, even in the era of modern laparoscopy. Not a lot of research has been performed on molecules that involved. Studies have tried to associate certain techniques during IVF, with this entity, but with controversial results. There is no standard form for diagnosing, dealing and presenting heterotopic pregnancies. Most of them are diagnosed when ruptured. Because it is rare event, costeffectiveness studies could not be performed and this complication is added to the overall IVF. Knowledge, on this field, is taken from the management of ectopic pregnancies in the general population, even if these present at a lower percentage. The purpose of the study is to systematically evaluate studies on molecular aspects of ectopic pregnancy, the ART techniques that are associated with ectopic pregnancy, the diagnosis of this entity and finally present case reports of heterotopic pregnancies and their management. At the end, cost-effectiveness models from the general population will be presented in parallel with systematic examination of these studies. Finally, new research targets will be pointed.