Ectopic pregnancies after in vitro fertilization and embryo transfer
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Our objective was to analyze the risk factors, stimulation characteristics, and future fecundity of patients with ectopic pregnancies after in vitro fertilization (IVF).
We retrospectively evaluated all cases of ectopic pregnancy occurring between January 1989 and March 1993 (Cornell series 1 to 17). A case-control group of intrauterine pregnancies was used for comparison of the stimulation and transfer characteristics.
Twenty-seven of 1123 pregnancies (2.4%) were ectopic, following 2812 fresh IVF embryo transfers, while 8 of 105 pregnancies (7.6%) were ectopic, following 405 frozen-thawed embryo transfers. Tubal factor was the cause of infertility in the majority (85.7%) of ectopic pregnancies. No difference was found between the ectopics and the matched controls in stimulation and transfer characteristics. Thirty ectopic pregnancies were ampullary, two were interstitial, two were cervical, and one was heterotopic. Twenty of the patients subsequently underwent 29 IVF attempts, with a pregnancy rate of 41.4% per transfer.
Ectopic pregnancy after IVF appears to be related to preexisting tubal pathology; embryo transfer of cryopreserved thawed embryos in a natural cycle may result in a higher ectopic rate in these patients; in subsequent IVF cycles the intrauterine pregnancy rate of these patients is not decreased.
Key wordsectopic pregnancy in vitro fertilization-embryo transfer
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- 1.Steptoe P, Edwards R: Reimplantation of a human embryo with subsequent tubal pregnancy. Lancet 1976;1:880–882Google Scholar
- 5.Medical Research International and the Society for Assisted Reproductive Technology, American Fertility Society: In vitro fertilization-embryo transfer in the United States: 1988 results from the IVF-ET registry. Fertil Steril 1990;53:13–20Google Scholar
- 6.Medical Research International and the Society for Assisted Reproductive Technology, American Fertility Society: In vitro fertilization-embryo transfer in the United States: 1989 results from the IVF-ET registry. Fertil Steril 1991;55:14–23Google Scholar
- 7.Medical Research International and the Society for Assisted Reproductive Technology, American Fertility Society: In vitro fertilization-embryo transfer in the United States: 1990 results from the IVF-ET registry. Fertil Steril 1992;57:15–24Google Scholar
- 8.Society for Assisted Reproductive Technology and American Fertility Society: Assisted reproductive technology in the United States and Canada: 1991 results from the SART generated from the AFS registry. Fertil Steril 1993;59:956–962Google Scholar
- 10.Cohen J, Mayaux MJ, Guihard-Moscato ML: Pregnancy outcomes after in-vitro fertilization: A collaborative study on 2342 pregnancies. Ann NY Acad Sci 1988, 541:1–6Google Scholar
- 16.Knutzen UK, Sotto-Albors CE, Fuller D, Sher G, Shyrock K, Behr B: Mock embryo transfer (MET) in early luteal phase, the cycle prior to in vitro fertilization and embryo transfer (IVF/ET). Presented at the 45th Annual Meeting of the American Fertility Society, San Francisco, CA, Nov 13 to 16, 1989. American Fertility Society, Program supplement 1989;pS152:299Google Scholar
- 20.Okamoto SH, Healy DL, Morrow LM, Rogers PA, Trounson AO, Wood EC: Predictive value of plasma human chorionic gonadotropin β-subunit in diagnosis ectopic pregnancy after in vitro fertilization and embryo transfer. Br Med J 1987;294:667–670Google Scholar
- 25.Rizk B, Tan SL, Morcos S, Riddle A, Brinsden P, Mason BA, Edwards RG: Heterotopic pregnancies after in vitro fertilization and embryo transfer. Am J Obstet Gynecol 1991: 164Google Scholar
- 26.Steptoe PC: Pregnancies following implantation of human embryos grown in culture. Presented at the Scientific Meeting of the Royal College of Obstetricians and Gynaecologists, London, Jan 26, 1979. Royal College of Obstetricians and Gynaecologists, Program SupplementGoogle Scholar