Heterotopic Ovarian Pregnancy

Case series of primary ovarian pregnancy

“…The main risk factors for ovarian pregnancies are endometriosis, former operations on the adnexa, former infectious diseases, previous reproductive system pathology or infertility, in vitro fertilization with embryo transfer, polycystic ovarian disease, and the use of an intrauterine device (IUD) [3]. However it is unclear whether the rise is due to true increase in prevalence or simply a result of emergence of better and earler diagnosis methods such as better availability of earlier quantitive beta-HCG measurements, early and more precise transvaginal sonogram, and early use of laparoscopy [4][5][6]. Risk factors for ovarian pregnancy are similar to tubal pregnancy of which concurrent use of and IUD seems important.…”

Organ-preserving management of ovarian pregnancies by laparoscopic approach

“…Nevertheless, these hypotheses are still discussed controversially and may not play the significant role in the etiology that has been presumed (1,4,(15)(16)(17). However, it is unclear whether the rise of incidence is a true increase in prevalence or simply a result of better and earlier diagnosis of ectopic pregnancies due to the availability of earlier quantitative serum b-hCG measurements, early and more precise TVS, and early use of diagnostic laparoscopy and even operative pelviscopy (6,17,18).…”

“…It is postulated that the superficial form is correlated with endometriosis genitalis externa. The presumption is that fertilization occurs outside the ovary and that abundant granulosa cells of the zygote adhere to the ruptured follicle (18). The intrafollicular pattern allows division into two subunits.…”

“…Although methotrexate therapy might be effective in some cases (7,(33)(34)(35)(36), it is not suitable for first-line treatment of ovarian pregnancy. Diagnostic laparoscopy and simultaneous operative pelviscopy is the gold standard for the diagnosis and therapy of ectopic pregnancies, because it is prompt, is minimally invasive, takes less operative time, has a lower blood loss, is cost-effective, is associated with a reduced hospital stay, a limited postoperative analgesia requirement, a lower risk of adhesions, and a better visualization of the operative field, and has no medical side effects (18,25).…”