A history of adnexal surgery and tuberculosis are risk factors for ovarian pregnancy following assisted reproductive technology: a retrospective matched case-control study

Background Ovarian pregnancy (OP) is a rare form of ectopic pregnancy that poses significant medical challenges. With the advancement of assisted reproductive technology (ART) in recent decades, the clinical pregnancy rate among infertile women has risen. ART has been linked to the occurrence of OP. Methods A retrospective matched case-control study in a single-center setting involved a total of 16,398 infertility patients who underwent IVF/ICSI-ET between January 2007 and June 2018, including 10 women with OP, 16,076 women with intrauterine pregnancy (IUP), and 312 women withtubal pregnancy (TP).These groups were matched according to age (± 1 year) and gestational age (± 7 days) in a ratio of 1:4:4 and were divided into OP group (n = 7), TP group (n = 28), and IUP group (n = 28).The personal and clinical characteristics of patients in different groups were evaluated. Univariate and multivariate logistic regressions were conducted to identify the independent risk factors of OP. Results In our study, multivariate logistic regression analysis revealed that a history of adnexal surgery (crude odds ratio [OR] = 5.81, 95% confidence interval [CI]: 1.30–25.97, P = 0.02; adjusted OR = 10.22, 95% CI: 1.57–66.37, P = 0.01) and tuberculosis (TB) history (crude OR = 6.60, 95% CI: 1.28–34.02, P = 0.03; adjusted OR = 12.85, 95% CI: 1.40–117.73, P = 0.02) are risk factors for OP compared to the IUP group. Although the dosage of gonadotropin did not differ among the three groups, a significant disparity was observed in serum β-hCG levels on the 14th day of embryo transfer (P < 0.001). Additionally, OP patients exhibited higher β-hCG levels compared to TP patients (918.35 ± 805.38 vs. 254.29 ± 215.82, P = 0.0005). Conclusions Among infertile women undergoing ART, risk factors for OP include a history of adnexal surgery and TB. Furthermore, OP patients tend to have higher β-hCG levels than TP patients on the 14th day of embryo transfer.