Risk Factors and Early Predictors for Heterotopic Pregnancy after In Vitro Fertilization

Abstract

This study investigated the risk factors and early predictors for heterotopic pregnancy (HP) after in vitro fertilization and embryo transfer (IVF-ET). From January 2008 to January 2013, 41 cases of HP and 72 cases of intrauterine twin pregnancy after IVF-ET were recruited and retrospectively analyzed. Compared with intrauterine twin pregnancy group, the HP group had a lower basal luteinizing hormone (LH) level (P = 0.005) and more cases had a history of hydrosalpinx (P = 0.008). After 14 days of IVF-ET, the serum β-HCG (β-human chorionic gonadotropin), E2 (Estradiol) and P (Progesterone) levels were lower in HP group (P<0.001, respectively). Moreover, vaginal bleeding and abdominal pain were the significant features of HP before diagnosis (P<0.001, respectively). Further by logistic regression, serum β-hCG, P levels on the 14th day after ET, and vaginal bleeding were identified as the independent factors of HP. These results indicate that when two or more embryos transferred in IVF procedure, β-hCG, P levels on the 14th day after ET, and vaginal bleeding could be taken as predictors for HP.

Study on the incidence and influences on heterotopic pregnancy from embryo transfer of fresh cycles and frozen-thawed cycles

“…Multiple studies have demonstrated that women with tubal factor infertility have an increased risk of ectopic pregnancy after ART compared with those with other types of infertility diagnoses. Tubal infertility has been shown to be a risk factor for HP cases among women treated with IVF [3,8]. In our current study, PID and previous ectopic pregnancy were found to be risk factors, which were consistent with the findings of previous studies [3,24].…”

“…Widespread use of assisted reproductive technology (ART) has substantially increased the incidence of heterotopic pregnancy (HP)-a simultaneous intrauterine and ectopic pregnancy [1]. Despite the fact that IVF allows the direct transfer of embryos into the uterine cavity with the complete bypass of the fallopian tubes, heterotopic pregnancies are more common following IVF than natural conception and are a wellrecognized complication of IVF [1][2][3][4].…”

Reproductive and perinatal outcomes of a frozen embryo transfer in the programs of assisted reproductive technologies(literature review)

“…Частота гетеротопической беременности у пациенток после ЭКО увеличилась в последние годы, вероятно, из-за широкого использования ВРТ, увеличения частоты хирургических вмешательств на репродуктивных органах и частоты воспалительных заболеваний органов малого таза. Проведенные исследования продемонстрировали, что женщины с бесплодием трубно-перитонеального генеза имеют повышенный риск появления внематочной беременности после ВРТ по сравнению с женщинами, имеющими бесплодие иного генеза [16,17].…”

Heterotopic Pregnancy with Intrauterine Device: A Typical Case Report

“…The incidence of HP is estimated as in 30,000 spontaneous pregnancies and is more rare about 1/6,000,000 women years of use in intrauterine device (IUD) users [2][3][4][5]. History of ectopic pregnancy, abortion, Ovarian Hyperstimulation Syndrome (OHSS) and in vitro fertilization (IVF)-embryo transfer (ET) are notable risk factors of HP [6,7]. Due to its rarity, misdiagnosis and missed diagnosis usually happened in clinic.…”