{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T03:15:19Z","timestamp":1783394119650,"version":"3.54.6"},"reference-count":48,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"vor","delay-in-days":55,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100006260","name":"Technion - Israel Institute of Technology","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006260","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Gynecol Obstet"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To describe the demographic, clinical, laboratory, imaging, and surgical features of 15 histologically confirmed ovarian pregnancies (OP) and to contextualize these findings within a narrative literature overview in order to improve clinical recognition and facilitate earlier diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective multicenter case series was conducted across two university-affiliated hospitals between 2012 and 2024. Women with histologically confirmed OP were included. Demographic data, risk factors, presenting symptoms, \u03b2-hCG dynamics, ultrasound findings, operative details, and postoperative outcomes were collected and analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fifteen patients were identified. The mean age was 34.6\u2009\u00b1\u20094.2\u00a0years; 46.7% used an intrauterine device, 33.3% had prior cesarean delivery, and 13.3% conceived through assisted reproduction. Abdominal pain was the predominant symptom (86.7%), whereas vaginal bleeding occurred in 26.7%. The mean preoperative \u03b2-hCG level was 6,436\u2009\u00b1\u20095,570 mIU\/mL and serial measurements showed inappropriate rises. OP was suspected preoperatively in 53.3% of cases; identification appeared higher in cases with formal ultrasound (85.7%), although this observation is limited by differences in imaging setting and documentation.. Observed sonographic features included a hyperechoic peripheral ring and a Doppler pattern demonstrating a single dominant feeding vessel; A trilaminar endometrial pattern was not observed in evaluable cases. Rupture occurred in 73.3% of patients with a median blood loss of 300\u00a0mL (IQR 10\u20132000\u00a0mL). All patients were treated surgically with ovarian preservation, and postoperative day-1 \u03b2-hCG declined by 59\u2009\u00b1\u200912%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>OP commonly presents with abdominal pain and minimal bleeding and carries a high rupture risk. The described sonographic patterns may represent hypothesis-generating observations that could support clinical suspicion and warranting further study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00404-026-08460-w","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T15:35:39Z","timestamp":1778686539000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ovarian pregnancy: clinical characteristics, diagnostic challenges, and sonographic features\u2014a multicenter case series with narrative literature overview"],"prefix":"10.1007","volume":"313","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-4211-9526","authenticated-orcid":false,"given":"Adi","family":"Dayan-Schwartz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariel","family":"Zilberlicht","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadav","family":"Cohen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahoum","family":"Leen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzan","family":"Abd Elgani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liron","family":"Kogan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ari","family":"Reiss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronit","family":"Beck-Fruchter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Etty","family":"Daniel-Spiegel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"key":"8460_CR1","doi-asserted-by":"publisher","first-page":"3224","DOI":"10.1093\/humrep\/17.12.3224","volume":"17","author":"J Bouyer","year":"2002","unstructured":"Bouyer J, Coste J, Fernandez H et al (2002) Sites of ectopic pregnancy: a 10 year population-based study of 1800 cases. Hum Reprod 17:3224\u20133230. https:\/\/doi.org\/10.1093\/humrep\/17.12.3224","journal-title":"Hum Reprod"},{"key":"8460_CR2","doi-asserted-by":"publisher","DOI":"10.1186\/s12958-021-00761-w","volume":"19","author":"A Al Naimi","year":"2021","unstructured":"Al Naimi A, Moore P, Br\u00fcggmann D et al (2021) Ectopic pregnancy: a single-center experience over ten years. Reprod Biol Endocrinol 19:79. https:\/\/doi.org\/10.1186\/s12958-021-00761-w","journal-title":"Reprod Biol Endocrinol"},{"key":"8460_CR3","doi-asserted-by":"publisher","first-page":"899","DOI":"10.1007\/s00404-020-05648-6","volume":"302","author":"J-H Zheng","year":"2020","unstructured":"Zheng J-H, Liu M-D, Zhou X-J et al (2020) An investigation of the time trends, risk factors, role of ultrasonic preoperative diagnosis of 79 ovarian pregnancy. Arch Gynecol Obstet 302:899\u2013904. https:\/\/doi.org\/10.1007\/s00404-020-05648-6","journal-title":"Arch Gynecol Obstet"},{"key":"8460_CR4","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-022-05099-8","volume":"22","author":"H Li","year":"2022","unstructured":"Li H, Liu Y, Yang Y et al (2022) Clinical analysis of women with ovarian pregnancy: a retrospective case\u2013control study. BMC Pregnancy Childbirth 22:768. https:\/\/doi.org\/10.1186\/s12884-022-05099-8","journal-title":"BMC Pregnancy Childbirth"},{"key":"8460_CR5","doi-asserted-by":"publisher","first-page":"1473","DOI":"10.1007\/s00404-025-08185-2","volume":"312","author":"A Maleki-Hajiagha","year":"2025","unstructured":"Maleki-Hajiagha A, Karimi R, Emami N, Amidi F (2025) How embryo retention affects assisted reproductive technology outcomes: a systematic review and meta-analysis. Arch Gynecol Obstet 312:1473\u20131488. https:\/\/doi.org\/10.1007\/s00404-025-08185-2","journal-title":"Arch Gynecol Obstet"},{"key":"8460_CR6","doi-asserted-by":"publisher","first-page":"1661","DOI":"10.1148\/rg.286085506","volume":"28","author":"EP Lin","year":"2008","unstructured":"Lin EP, Bhatt S, Dogra VS (2008) Diagnostic clues to ectopic pregnancy. Radiographics 28:1661\u20131671. https:\/\/doi.org\/10.1148\/rg.286085506","journal-title":"Radiographics"},{"key":"8460_CR7","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-024-06441-y","volume":"24","author":"SK Mutiso","year":"2024","unstructured":"Mutiso SK (2024) Correlation of sonographic with intraoperative findings in laparoscopic managed ectopic pregnancies, a 10-year synopsis: a restrospective observational study. BMC Pregnancy Childbirth 24:296. https:\/\/doi.org\/10.1186\/s12884-024-06441-y","journal-title":"BMC Pregnancy Childbirth"},{"key":"8460_CR8","doi-asserted-by":"publisher","first-page":"920","DOI":"10.1016\/0002-9378(51)90179-2","volume":"62","author":"L Gerin-Lajoie","year":"1951","unstructured":"Gerin-Lajoie L (1951) Ovarian pregnancy. Am J Obstet Gynecol 62:920\u2013929. https:\/\/doi.org\/10.1016\/0002-9378(51)90179-2","journal-title":"Am J Obstet Gynecol"},{"key":"8460_CR9","first-page":"174","volume":"61","author":"HG Grimes","year":"1983","unstructured":"Grimes HG, Nosal RA, Gallagher JC (1983) Ovarian pregnancy: a series of 24 cases. Obstet Gynecol 61:174\u2013180","journal-title":"Obstet Gynecol"},{"key":"8460_CR10","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1016\/j.ejogrb.2011.04.015","volume":"158","author":"H-J Choi","year":"2011","unstructured":"Choi H-J, Im K-S, Jung H-J et al (2011) Clinical analysis of ovarian pregnancy: a report of 49 cases. Eur J Obstet Gynecol Reprod Biol 158:87\u201389. https:\/\/doi.org\/10.1016\/j.ejogrb.2011.04.015","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"8460_CR11","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-024-00579-x","volume":"10","author":"KY Chong","year":"2024","unstructured":"Chong KY, de Waard L, Oza M et al (2024) Ectopic pregnancy. Nat Rev Dis Primers 10:94. https:\/\/doi.org\/10.1038\/s41572-024-00579-x","journal-title":"Nat Rev Dis Primers"},{"key":"8460_CR12","first-page":"687","volume":"17","author":"Y Melcer","year":"2015","unstructured":"Melcer Y, Smorgick N, Vaknin Z et al (2015) Primary ovarian pregnancy: 43 years experience in a single institute and still a medical challenge. Isr Med Assoc J 17:687\u2013690","journal-title":"Isr Med Assoc J"},{"key":"8460_CR13","doi-asserted-by":"publisher","first-page":"1141","DOI":"10.1007\/s00404-023-07338-5","volume":"310","author":"Y Akda\u015f Reis","year":"2024","unstructured":"Akda\u015f Reis Y, Akay A, \u00d6zkan M et al (2024) Non-tubal ectopic pregnancy treatment experiences of a tertiary care center. Arch Gynecol Obstet 310:1141\u20131149. https:\/\/doi.org\/10.1007\/s00404-023-07338-5","journal-title":"Arch Gynecol Obstet"},{"key":"8460_CR14","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12031138","volume":"12","author":"Z Almahloul","year":"2023","unstructured":"Almahloul Z, Amro B, Nagshabandi Z et al (2023) Ovarian pregnancy: 2 case reports and a systematic review. J Clin Med 12:1138. https:\/\/doi.org\/10.3390\/jcm12031138","journal-title":"J Clin Med"},{"key":"8460_CR15","doi-asserted-by":"publisher","first-page":"815","DOI":"10.1002\/uog.27549","volume":"63","author":"SA Solangon","year":"2024","unstructured":"Solangon SA, Naftalin J, Jurkovic D (2024) Ovarian ectopic pregnancy: clinical characteristics, ultrasound diagnosis and management. Ultrasound Obstet Gynecol 63:815\u2013823. https:\/\/doi.org\/10.1002\/uog.27549","journal-title":"Ultrasound Obstet Gynecol"},{"key":"8460_CR16","doi-asserted-by":"publisher","first-page":"492","DOI":"10.4293\/108680812X13462882736385","volume":"16","author":"G Scutiero","year":"2012","unstructured":"Scutiero G, Di Gioia P, Spada A, Greco P (2012) Primary ovarian pregnancy and its management. JSLS 16:492\u2013494. https:\/\/doi.org\/10.4293\/108680812X13462882736385","journal-title":"JSLS"},{"key":"8460_CR17","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2022.1036365","volume":"13","author":"F Ren","year":"2022","unstructured":"Ren F, Liu G, Wang T et al (2022) Unruptured ovarian ectopic pregnancy: two case reports and literature review. Front Physiol 13:1036365. https:\/\/doi.org\/10.3389\/fphys.2022.1036365","journal-title":"Front Physiol"},{"key":"8460_CR18","unstructured":"Linh K Phan NTH (2022) Ovarian Ectopic Pregnancy. In: Vis. Encycl. Ultrasound Obstet. Gynecol. https:\/\/www.isuog.org\/education\/visuog\/obstetrics\/early-pregnancy\/ectopic-pregnancy\/uterine-ectopic-pregnancy\/ovarian-ectopic-pregnancy.html?utm_source=perplexity. Accessed 21 July 2025"},{"key":"8460_CR19","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-006447","volume":"4","author":"Q Zhu","year":"2014","unstructured":"Zhu Q, Li C, Zhao W-H et al (2014) Risk factors and clinical features of ovarian pregnancy: a case-control study. BMJ Open 4:e006447. https:\/\/doi.org\/10.1136\/bmjopen-2014-006447","journal-title":"BMJ Open"},{"key":"8460_CR20","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1016\/S0015-0282(16)56057-9","volume":"60","author":"SF Marcus","year":"1993","unstructured":"Marcus SF, Brinsden PR (1993) Primary ovarian pregnancy after in vitro fertilization and embryo transfer: report of seven cases. Fertil Steril 60:167\u2013169. https:\/\/doi.org\/10.1016\/S0015-0282(16)56057-9","journal-title":"Fertil Steril"},{"key":"8460_CR21","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2023.1062228","volume":"10","author":"M Shao","year":"2023","unstructured":"Shao M, Wang X, Zhou X (2023) Case report: Ovarian pregnancy, a rare but lethal condition: an analysis of 112 cases. Front Surg 10:1062228. https:\/\/doi.org\/10.3389\/fsurg.2023.1062228","journal-title":"Front Surg"},{"key":"8460_CR22","first-page":"825","volume":"12","author":"LD Goyal","year":"2014","unstructured":"Goyal LD, Tondon R, Goel P, Sehgal A (2014) Ovarian ectopic pregnancy: a 10 years\u2019 experience and review of literature. Iran J Reprod Med 12:825\u2013830","journal-title":"Iran J Reprod Med"},{"key":"8460_CR23","doi-asserted-by":"publisher","first-page":"1131","DOI":"10.1016\/0002-9378(69)90518-3","volume":"103","author":"M Kobayashi","year":"1969","unstructured":"Kobayashi M, Hellman LM, Fillisti LP (1969) Ultrasound. An aid in the diagnosis of ectopic pregnancy. Am J Obstet Gynecol 103:1131\u20131140","journal-title":"Am J Obstet Gynecol"},{"key":"8460_CR24","doi-asserted-by":"publisher","first-page":"259","DOI":"10.7863\/jum.1994.13.4.259","volume":"13","author":"DL Brown","year":"1994","unstructured":"Brown DL, Doubilet PM (1994) Transvaginal sonography for diagnosing ectopic pregnancy: positivity criteria and performance characteristics. J Ultrasound Med 13:259\u2013266. https:\/\/doi.org\/10.7863\/jum.1994.13.4.259","journal-title":"J Ultrasound Med"},{"key":"8460_CR25","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1093\/humupd\/dmt047","volume":"20","author":"E Kirk","year":"2014","unstructured":"Kirk E, Bottomley C, Bourne T (2014) Diagnosing ectopic pregnancy and current concepts in the management of pregnancy of unknown location. Hum Reprod Update 20:250\u2013261. https:\/\/doi.org\/10.1093\/humupd\/dmt047","journal-title":"Hum Reprod Update"},{"key":"8460_CR26","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1007\/s00404-025-08069-5","volume":"312","author":"A Darwish","year":"2025","unstructured":"Darwish A, Avishalom S, Sgayer I et al (2025) Distinguishing tubal rupture from tubal abortion in ectopic pregnancies after methotrexate treatment: a retrospective cohort study. Arch Gynecol Obstet 312:833\u2013839. https:\/\/doi.org\/10.1007\/s00404-025-08069-5","journal-title":"Arch Gynecol Obstet"},{"key":"8460_CR27","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1375\/twin.12.2.180","volume":"12","author":"J Woo","year":"2009","unstructured":"Woo J, Tong S, Campbell MJ et al (2009) Two corpora lutea seen at 6\u201313 weeks\u2019 gestation infers dizygosity among spontaneous same-sexed dichorionic twins. Twin Res Hum Genet 12:180\u2013182. https:\/\/doi.org\/10.1375\/twin.12.2.180","journal-title":"Twin Res Hum Genet"},{"key":"8460_CR28","doi-asserted-by":"publisher","first-page":"2234","DOI":"10.1093\/humrep\/dex285","volume":"32","author":"S Mackens","year":"2017","unstructured":"Mackens S, Santos-Ribeiro S, van de Vijver A et al (2017) Frozen embryo transfer: a review on the optimal endometrial preparation and timing. Hum Reprod 32:2234\u20132242. https:\/\/doi.org\/10.1093\/humrep\/dex285","journal-title":"Hum Reprod"},{"key":"8460_CR29","doi-asserted-by":"publisher","first-page":"1370","DOI":"10.1016\/j.ajog.2004.12.039","volume":"192","author":"AO Hammoud","year":"2005","unstructured":"Hammoud AO, Hammoud I, Bujold E et al (2005) The role of sonographic endometrial patterns and endometrial thickness in the differential diagnosis of ectopic pregnancy. Am J Obstet Gynecol 192:1370\u20131375. https:\/\/doi.org\/10.1016\/j.ajog.2004.12.039","journal-title":"Am J Obstet Gynecol"},{"key":"8460_CR30","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1002\/ijgo.12020","volume":"136","author":"P Yadav","year":"2017","unstructured":"Yadav P, Singla A, Sidana A et al (2017) Evaluation of sonographic endometrial patterns and endometrial thickness as predictors of ectopic pregnancy. Int J Gynaecol Obstet 136:70\u201375. https:\/\/doi.org\/10.1002\/ijgo.12020","journal-title":"Int J Gynaecol Obstet"},{"key":"8460_CR31","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1002\/(SICI)1097-0096(199605)24:4<179::AID-JCU4>3.0.CO;2-C","volume":"24","author":"O Lavie","year":"1996","unstructured":"Lavie O, Boldes R, Neuman M et al (1996) Ultrasonographic \u201cendometrial three-layer\u201d pattern: a unique finding in ectopic pregnancy. J Clin Ultrasound JCU 24:179\u2013183","journal-title":"J Clin Ultrasound JCU"},{"key":"8460_CR32","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/934571","volume":"2012","author":"N Gupta","year":"2012","unstructured":"Gupta N, Gupta A, Onyema G et al (2012) Accurate preoperative diagnosis of ovarian pregnancy with transvaginal scan. Case Rep Obstet Gynecol 2012:934571. https:\/\/doi.org\/10.1155\/2012\/934571","journal-title":"Case Rep Obstet Gynecol"},{"key":"8460_CR33","doi-asserted-by":"publisher","first-page":"4323","DOI":"10.18203\/2320-1770.ijrcog20214354","volume":"10","author":"A Singhal","year":"2021","unstructured":"Singhal A, Kottiyath VC, Gupta TP, Arora P (2021) MRI findings in ruptured ovarian ectopic pregnancy: an unexplored avenue. Int J Reprod Contracept Obstet Gynecol 10:4323\u20134327. https:\/\/doi.org\/10.18203\/2320-1770.ijrcog20214354","journal-title":"Int J Reprod Contracept Obstet Gynecol"},{"key":"8460_CR34","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1016\/j.ejrad.2017.05.023","volume":"93","author":"S Srisajjakul","year":"2017","unstructured":"Srisajjakul S, Prapaisilp P, Bangchokdee S (2017) Magnetic resonance imaging in tubal and non-tubal ectopic pregnancy. Eur J Radiol 93:76\u201389. https:\/\/doi.org\/10.1016\/j.ejrad.2017.05.023","journal-title":"Eur J Radiol"},{"key":"8460_CR35","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1007\/BF01991416","volume":"13","author":"O Spiegelberg","year":"1878","unstructured":"Spiegelberg O (1878) Zut casuistik der ovarial schwangersehaft. Arch Gynaekol 13:73\u201377","journal-title":"Arch Gynaekol"},{"key":"8460_CR36","first-page":"774","volume":"33","author":"RJ Van Coevering","year":"1988","unstructured":"Van Coevering RJ, Fisher JE (1988) Laparoscopic management of ovarian pregnancy. A case report. J Reprod Med 33:774\u2013776","journal-title":"J Reprod Med"},{"key":"8460_CR37","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1016\/j.jmig.2009.01.002","volume":"16","author":"F Odejinmi","year":"2009","unstructured":"Odejinmi F, Rizzuto MI, Macrae R et al (2009) Diagnosis and laparoscopic management of 12 consecutive cases of ovarian pregnancy and review of literature. J Minim Invasive Gynecol 16:354\u2013359. https:\/\/doi.org\/10.1016\/j.jmig.2009.01.002","journal-title":"J Minim Invasive Gynecol"},{"key":"8460_CR38","doi-asserted-by":"publisher","first-page":"1006","DOI":"10.1016\/j.jmig.2018.12.017","volume":"26","author":"N Kaur","year":"2019","unstructured":"Kaur N, Reid F, Ma K (2019) Ovarian ectopic pregnancy: laparoscopic excision and ovarian conservation. J Minim Invasive Gynecol 26:1006. https:\/\/doi.org\/10.1016\/j.jmig.2018.12.017","journal-title":"J Minim Invasive Gynecol"},{"key":"8460_CR39","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1186\/s13256-015-0774-6","volume":"9","author":"O Birge","year":"2015","unstructured":"Birge O, Erkan MM, Ozbey EG, Arslan D (2015) Medical management of an ovarian ectopic pregnancy: a case report. J Med Case Rep 9:290. https:\/\/doi.org\/10.1186\/s13256-015-0774-6","journal-title":"J Med Case Rep"},{"key":"8460_CR40","doi-asserted-by":"publisher","first-page":"879","DOI":"10.1016\/s0015-0282(16)57020-4","volume":"62","author":"D Chelmow","year":"1994","unstructured":"Chelmow D, Gates E, Penzias AS (1994) Laparoscopic diagnosis and methotrexate treatment of an ovarian pregnancy: a case report. Fertil Steril 62:879\u2013881. https:\/\/doi.org\/10.1016\/s0015-0282(16)57020-4","journal-title":"Fertil Steril"},{"key":"8460_CR41","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1080\/01443610600831357","volume":"26","author":"J Habbu","year":"2006","unstructured":"Habbu J, Read MD (2006) Ovarian pregnancy successfully treated with methotrexate. J Obstet Gynaecol J Inst Obstet Gynaecol 26:587\u2013588. https:\/\/doi.org\/10.1080\/01443610600831357","journal-title":"J Obstet Gynaecol J Inst Obstet Gynaecol"},{"key":"8460_CR42","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1016\/j.jmig.2012.10.012","volume":"20","author":"K Pagidas","year":"2013","unstructured":"Pagidas K, Frishman GN (2013) Nonsurgical management of primary ovarian pregnancy with transvaginal ultrasound-guided local administration of methotrexate. J Minim Invasive Gynecol 20:252\u2013254. https:\/\/doi.org\/10.1016\/j.jmig.2012.10.012","journal-title":"J Minim Invasive Gynecol"},{"key":"8460_CR43","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2012-007112","volume":"2012","author":"S Hassan","year":"2012","unstructured":"Hassan S, Arora R, Bhatia K (2012) Primary ovarian pregnancy: case report and review of literature. BMJ Case Rep 2012:bcr2012007112. https:\/\/doi.org\/10.1136\/bcr-2012-007112","journal-title":"BMJ Case Rep"},{"key":"8460_CR44","doi-asserted-by":"publisher","first-page":"638","DOI":"10.1016\/j.fertnstert.2013.06.013","volume":"100","author":"Practice Committee of American Society for Reproductive Medicine","year":"2013","unstructured":"Practice Committee of American Society for Reproductive Medicine (2013) Medical treatment of ectopic pregnancy: a committee opinion. Fertil Steril 100:638\u2013644. https:\/\/doi.org\/10.1016\/j.fertnstert.2013.06.013","journal-title":"Fertil Steril"},{"key":"8460_CR45","doi-asserted-by":"publisher","first-page":"1200.e1","DOI":"10.1016\/j.fertnstert.2007.11.051","volume":"90","author":"Y-C Juan","year":"2008","unstructured":"Juan Y-C, Wang P-H, Chen C-H et al (2008) Successful treatment of ovarian pregnancy with laparoscopy-assisted local injection of etoposide. Fertil Steril 90:1200.e1-1200.e2. https:\/\/doi.org\/10.1016\/j.fertnstert.2007.11.051","journal-title":"Fertil Steril"},{"key":"8460_CR46","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1080\/02841850600644782","volume":"47","author":"RV Ramanan","year":"2006","unstructured":"Ramanan RV, Gajaraj J (2006) Ectopic pregnancy--the leash sign. A new sign on transvaginal Doppler ultrasound. Acta Radiol 47:529\u2013535. https:\/\/doi.org\/10.1080\/02841850600644782","journal-title":"Acta Radiol"},{"key":"8460_CR47","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1186\/s13244-025-02079-2","volume":"16","author":"N Su","year":"2025","unstructured":"Su N, Fu L-R, Du Z et al (2025) Novel ultrasound classification of tubal ectopic pregnancy: exploring underlying connections among sonographic and serum markers. Insights Imaging 16:195. https:\/\/doi.org\/10.1186\/s13244-025-02079-2","journal-title":"Insights Imaging"},{"key":"8460_CR48","first-page":"207","volume":"30","author":"CS Feldkamp","year":"1982","unstructured":"Feldkamp CS, Pfeffer WH (1982) The measurement of human chorionic gonadotropin for pregnancy testing. Henry Ford Hosp Med J 30:207\u2013213","journal-title":"Henry Ford Hosp Med J"}],"container-title":["Archives of Gynecology and Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00404-026-08460-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00404-026-08460-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00404-026-08460-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T02:41:49Z","timestamp":1783392109000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00404-026-08460-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,13]]},"references-count":48,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["8460"],"URL":"https:\/\/doi.org\/10.1007\/s00404-026-08460-w","relation":{},"ISSN":["1432-0711"],"issn-type":[{"value":"1432-0711","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,13]]},"assertion":[{"value":"30 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"IRB: The study was approved in 7\/2024 by the Institutional Review Board (IRB), at Emek Medical Center (#EMC-0069\u201424), Afula, Israel and by the IRB of Carmel Medical Center, Haifa, Israel (approval #CMC-0173\u201424, December 2024).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Patient consent for publication was not required, as this retrospective study included only anonymized data without any identifiable patient information..","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Patient consent"}}],"article-number":"217"}}