ArticleActa obstetricia et gynecologica Scandinavica2022
Top-quality embryo transfer is associated with lower odds of ectopic pregnancy.
Article in Acta obstetricia et gynecologica Scandinavica, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.
- ESHRE guideline: number of embryos to transfer during IVF/ICSI†.Human reproduction (Oxford, England) · 2024Guideline
- A prospective pilot study on DACHAO intervention for improving embryo quality metrics in IVF/ICSI failure cases.Frontiers in cell and developmental biology · 2026Article
- The diagnosis and management of extrauterine and uterine ectopic pregnancy.Human reproduction update · 2026Review
- Development and validation of a nomogram for predicting ectopic pregnancy in patients receiving double fresh cleavage stage embryo transfer.Scientific reports · 2025Article
- The Evolution of In Vitro Fertilization Practices in Saudi Arabia: Historical Perspectives and Future Directions.Cureus · 2025Review
- Assessing the risk of ectopic pregnancy following euploid frozen embryo transfer: a retrospective cohort study.Journal of assisted reproduction and genetics · 2025Article
- The construction of machine learning-based predictive models for high-quality embryo formation in poor ovarian response patients with progestin-primed ovarian stimulation.Reproductive biology and endocrinology : RB&E · 2024Article
- Body mass index impacts ectopic pregnancy during in vitro fertilization: an analysis of 42,362 clinical pregnancy cycles.Reproductive biology and endocrinology : RB&E · 2023Article
- Higher obstetric and perinatal risks for twins and the need for single embryo transfers in assisted reproduction.Acta obstetricia et gynecologica Scandinavica · 2023Article
- Top-quality embryo transfer is associated with lower odds of ectopic pregnancy.Acta obstetricia et gynecologica Scandinavica · 2022Article
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11 authors at 7 institutions in 2 countries.
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No grant is acknowledged in the PubMed record.
Abstract
introductionThe incidence of ectopic pregnancy is up to four times higher after in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) than in spontaneous pregnancies, and the risk of ectopic pregnancy is increased by tubal factor infertility and the transfer of multiple embryos. However, the effect of embryo quality on the probability of ectopic pregnancy has not been investigated until now and it is not clear whether ovarian stimulation parameters affect the incidence of ectopic pregnancy. MATERIAL AND
methodsAn historical cohort study of 15 006 clinical pregnancies (diagnosed by ultrasound at 6-8 gestational weeks) after non-donor IVF/ICSI with fresh embryo transfer (n = 8952) or frozen-thawed embryo transfer (n = 6054). Treatments were performed during 2000-2017 in Finland. A total of 9207 (61.4%) single and 5799 (38.6%) double embryo transfers of no more than one top-quality embryo were evaluated. We analyzed the effects of multiple factors on ectopic pregnancy by logistic regression, including type of cycle (fresh vs frozen embryo transfer), female age, number and quality of embryos transferred, tubal factor infertility and factors of ovarian response to gonadotropin stimulation.
resultsEctopic pregnancy was observed in 2.3% of cycles. There was no significant difference in ectopic pregnancy rate after fresh embryo transfer and frozen embryo transfer (2.2% vs 2.4%, p = 0.3). The ectopic pregnancy rate was lower in cycles with top-quality embryo transfer (1.9%) than of those where only non-top quality embryos were transferred (2.7%, p < 0.0001). Tubal factor infertility was diagnosed more often in ectopic pregnancy than in intrauterine pregnancies (21.2% vs 11.0%, p < 0.0001). Logistic regression revealed lower odds for ectopic pregnancy after a top-quality embryo transfer than after transfer of a non-top quality embryo (odds ratio [OR] 0.72, 95% confidence interval [CI] 0.56-0.92, p = 0.007). Transfer of two vs one embryo (OR 1.35, 95% CI 1.05-1.70, p = 0.02) and tubal factor infertility (OR 2.21, 95% CI 1.68-2.91, p < 0.0001) significantly increased the risk of ectopic pregnancy.
conclusionsTransfer of non-top quality embryos is associated with a higher rate of ectopic pregnancy. This is particularly important to keep in mind in treatments with only non-top embryos available even in the absence of tubal factor infertility. To minimize the risk of ectopic pregnancy, the number of embryos transferred should be as low as possible.
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