What’s new in assisted reproduction research? A 40-year review reveals changing priorities
image: Trends in publication volume (1304 documents) and citation counts from 1982 to 2024. Both metrics remained relatively low between 1982 and 2010. However, a clear upward trajectory emerged beginning in 2011, with a pronounced surge from 2019 to 2022, indicating that the field entered a phase of accelerated growth during this period.
Credit: Su Mao; Yu-Xin Dai.
Assisted reproductive technology (ART) has transformed infertility treatment, helping many people achieve pregnancy through procedures such as in vitro fertilization and embryo transfer. However, ART is also associated with a two- to fivefold higher risk of ectopic pregnancy compared with natural conception. Ectopic pregnancy occurs when an embryo implants outside the main cavity of the uterus, most commonly in a fallopian tube, and can pose serious health risks if not detected and treated early.
Su Mao and Yu-Xin Dai of Peking Union Medical College Hospital, China, analyzed 1,304 articles published between 1982 and April 2024. The records were obtained from the Web of Science Core Collection and assessed using three bibliometric tools: CiteSpace, VOSviewer, and the R package bibliometrix.
Publication and citation numbers remained relatively low until 2010 but increased substantially after 2011, with the strongest growth occurring from 2019 to 2022. China produced the largest number of included articles, with 335 publications, followed by the United States with 187. Shanghai Jiao Tong University (China) and Shandong University (China) were the most productive institutions.
Collaboration patterns formed several major regional networks, including groups centered on China and the United States, a Central European-Nordic network, and a network connecting the United Kingdom, continental Europe, and India. However, institutions in the same country or neighboring regions generally collaborated more closely than geographically distant organizations.
The analysis also showed how research priorities have changed over time. Earlier studies focused mainly on understanding and managing complications associated with assisted reproduction, including heterotopic pregnancy, donor oocytes, cryopreserved embryos, and treatments such as methotrexate and laparoscopy. As ART became more widely used and clinical priorities expanded beyond achieving pregnancy alone, research gradually shifted toward understanding the factors that influence treatment safety, implantation, and pregnancy outcomes. Recent studies have increasingly examined embryo transfer strategies, endometrial thickness, live birth outcomes, and recurrent implantation failure. This evolution reflects a broader shift from managing complications after they occur to understanding their underlying factors and optimizing assisted reproduction strategies.
However, the authors cautioned that their analysis maps publication trends, citations, and research networks rather than evaluating detailed clinical evidence. Because it relied only on Web of Science, it may also underrepresent non-English and regional studies. The findings should therefore be used to understand research priorities, collaboration patterns, and remaining knowledge gaps, not as clinical recommendations.
The study was published in Reproductive and Developmental Medicine.