• Xinyu Zhang, Caihong Ma, Zhangxin Wu, Liyuan Tao, Rong Li, Ping Liu, and Jie Qiao.
• 1 Reproductive Medicine Center, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, People's Republic of China.
• Reprod Sci. 2018 Sep 1; 25 (9): 1431-1435.

ObjectiveTo evaluate the risk of ectopic pregnancy of embryo transfer.DesignA retrospective cohort study on the incidence of ectopic pregnancy in fresh and frozen-thawed embryo transfer cycles from January 1st, 2010, to January 1st, 2015.PatientsInfertile women undergoing frozen-thawed transfer cycles or fresh transfer cycles.InterventionIn-vitro fertilization, fresh embryo transfer, frozen-thawed embryo transfer, ectopic pregnancy.Main Outcome MeasuresEctopic pregnancy rate and clinical pregnancy rate.ResultA total of 69 756 in vitro fertilization-embryo transfer cycles from 2010 to 2015 were analyzed, including 45 960 (65.9%) fresh and 23 796 (34.1%) frozen-thawed embryo transfer cycles. The clinical pregnancy rate per embryo transfer was slightly lower in fresh embryo transfer cycles compared with frozen-thawed embryo transfer cycles (40.8% vs 43.1%, P < .001). Frozen-thawed embryo transfer is associated with a lower incidence of ectopic pregnancy per clinical pregnancy, compared with fresh embryo transfers (odds ratio = 0.31; 95% confidence interval = 0.24-0.39). Female age and body mass index have no influence on ectopic pregnancy. In the frozen-thawed embryo transfer cycles, blastocyst transfer shows a significantly lower incidence of ectopic pregnancy (0.8% vs 1.8%, P = .002) in comparison with day 3 cleavage embryo transfer.ConclusionThe risk of ectopic pregnancy is lower in frozen-thawed embryo transfer cycles than fresh embryo transfer cycles, and blastocyst transfer could further decrease the ectopic pregnancy rate in frozen-thawed embryo transfer cycles.

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