Previous tubal ectopic pregnancy raises the incidence of repeated ectopic pregnancies in In Vitro fertilization-embryo transfer patients

Abstract

Purpose To investigate the incidence of Tubal Ectopic Pregnancies (TEP) in IVF-ET patients with respect to the status of the fallopian tubes after a previous TEP. Material and methods This retrospective study compares patients undergoing 481 IVF-ET cycles after conservatively or surgically treated TEP(s) with a Control Group (idiopathic or male factor for IVF-ET indication). Medical reports of surgery and/or hysterosalpingograms prior to the IVF cycles classified the status of the fallopian tubes. Results 12 TEPs (8.95%/Pregnancies (PR)) occurred in the Study Group. In the Control Group one TEP (0.75%/PR; p<0.001) was found. Smoking increased the probability of TEPs (p=0.0028) and of pathological pregnancies (abortion, biochemical and ectopic PR; (p=0.0411)). For statistic evolution logistic regression (PROC GENMOD) and a repeated measure model were applied. Conclusion Women with a previous TEP should be informed about the significantly increased risk for a further TEP in IVF-ET treatment, especially if they are smoking.

Risk of Ectopic Pregnancy Associated With Assisted Reproductive Technology in the United States, 2001–2011

“…25 Similar to a previous report, 21 we saw a dose–response relationship between the risk of ectopic pregnancy and the number of embryos transferred during an ART cycle. Although earlier studies have not demonstrated this trend, 4,10,12,15 more recent investigations are consistent with our findings, 21,26 likely as a result of improvements in IVF techniques resulting in improved implantation potential, and increased odds of extrauterine implantation. Although the use of ultrasound guidance during embryo transfer procedures has increased since the late 1990s, a recent meta-analysis showed no improvement in ectopic pregnancy rates with its use.…”

Incidence, diagnosis and management of tubal and nontubal ectopic pregnancies: a review

“…Prior treatment for EP, whether medical or surgical, may result in pathologic changes in tubal motility, ciliary function and uterine contractions [41]. (For fertility outcomes after prior EP, please see “Recurrence and future fertility”).…”

Ectopic pregnancy after assisted reproductive technology: what are the risk factors?

“…Weigert et al [16] investigated the influence of the condition of the fallopian tubes in women who experienced a tubal ectopic pregnancy in a previous pregnancy, on the incidence of a repeated tubal pregnancy in an IVF-ET cycle. Women with a prior tubal ectopic pregnancy significantly increased the risk per pregnancy for a further ectopic pregnancy even in IVF-ET (8.95 vs. 0.75%, P < 0.001), especially if they are smoking.…”