Arch Gynecol Obstet (2008) 278:191–193 DOI 10.1007/s00404-008-0562-2 123 CASE REPORT Ovarian ectopic pregnancy after ICSI-ET: a case report and literature review Polat Dursun · Murat Gultekin · Hulusi B. Zeyneloglu Received: 28 December 2007 / Accepted: 3 January 2008 / Published online: 31 January 2008  Springer-Verlag 2008 Abstract Introduction Primary ovarian ectopic pregnancy (OEP) is one of the the rarest form of extratubal pregnancies and its pathophysciological mechanism is not fully understood. On the otherhand, OEP after intra-cytoplasmic sperm injection with embryo transfer (ICSI-ET) is even more rare and just a few cases have been reported in literature. Materials and methods A case with OEP after ICSI-ET presented and managed by conservative laparoscopic approach. Also, literature associated with OEP after ICSI- ET have been summarized. Pubmed search using “Ovarian ectopic pregnancy” and “ICSI-ET” keywords revealed four similar case in the literature. Conclusion Underlying pathophysiological mechanism of OEP after ICSI-ET is unclear. Indeed, gynecologists should be aware about the development of the OEP after ICSI-ET. Early diagnosis will give the opportunity to use conserva- tive managements for these infertile patients. Keywords Ectopic pregnancy · Ovarian ectopic pregnancy · Intracytoplasmic sperm injection · Embrio transfer · IVF · Laparoscopy Introduction Extrauterine pregnancies remain one of the most common causes of pregnancy related deaths in both developed and undeveloped countries. On the other hand, their incidence is rising as a consequence of the increasing usage of assisted reproductive technologies (ART), more frequent performance of tubal surgery, and increasing number of pelvic inXammatory disease among females. Ectopic preg- nancies are mostly located in the fallopian tubes. However, it may also be seen in the cervix, ovaries, abdomen, and some other rare localizations in the abdomen, such as cae- cum, liver, abdominal wall, spleen, etc. Risks factors appear to be similar for both tubal and extratubal ectopic pregnancies [1]. Primary ovarian ectopic pregnancy (OEP) is one of the rarest extratubally localized ectopic pregnan- cies with a reported incidence of from 1 in 7,000 to 1 in 60,000 pregnancies and accounts for about 1–3% of all extrauterine pregnancies [2]. Ovarian ectopic pregnancy (OEP) is a very rare entity and its pathophysiologic mechanism is still not clear. On the other hand, OEP after intra-cytoplasmic sperm injection with embryo trans- fer (ICSI-ET) is even more rare and just a few cases have been reported in literature. In this report, we present a case with OEP after ICSI-ET. To the best of our knowledge, only four similar cases have been previously reported in the literature. Case history A 31-year-old secondary infertile women was admitted on lower abdominal pain to our hospital 41 days after ICSI-ET was performed in an IVF center in Turkey. On abdominal examination, there was a moderate abdominal tenderness. Pelvic examination revealed a tenderous left adnexal mass. Initial serum -HCG level was 1,634 U/ml. There was no intrauterine pregnancy on transvaginal USG. During the follow-up, hematocrit levels decreased and abdominal pain increased. Therefore, laparoscopy was performed with the P. Dursun (&) · M. Gultekin · H. B. Zeyneloglu Department of Obstetrics and Gynecology, Baskent University School of Medicine, Kubilay Sk. No:36 Maltepe, Ankara, Turkey e-mail: pdursun@ttnet.net.tr; pdursun@yahoo.com