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

Xiao, Shan; Mo, Meilan; Hu, Xiaodong; Zhang, Hongzhan; Xu, Shiru; Wang, Zhuran; Zeng, Yong

doi:10.1007/s10815-017-1109-x

Cited by 22 publications

(24 citation statements)

References 23 publications

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“…We also found that a previous history of EP and endometriosis were independent risk factors for EP in IVF/ET, which was consistent with the findings from previous studies 27282930. These results suggest that careful monitoring is necessary during the IVF/ET cycles in women with these risk factors.…”

Section: Discussionsupporting

confidence: 92%

Correlation between Ovarian Reserve and Incidence of Ectopic Pregnancy afterIn VitroFertilization and Embryo Transfer

Kim

Shin

et al. 2019

Yonsei Med J

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Purpose To elucidate the correlation between ovarian reserve and the incidence of ectopic pregnancy (EP) following in vitro fertilization and embryo transfer (IVF/ET) cycles. Materials and Methods In this observational study, 430 fresh IVF/ET cycles were examined from patient data of two university hospital infertility clinics. All included patients were positive for β-human chorionic gonadotropin (hCG) at 2 weeks after oocyte retrieval via controlled ovarian stimulation. For each cycle, information on age, duration of infertility, basal follicle stimulating hormone (FSH), anti-Müllerian hormone (AMH), days of ovarian stimulation, numbers of retrieved oocytes and transferred embryos, and pregnancy outcomes was collected. Patients with AMH lower than 1.0 ng/dL or basal FSH higher than 10 mIU/mL were classified into the decreased ovarian reserve (DOR) group, and the remaining patients were classified into the normal ovarian reserve (NOR) group. Results In total, 355 cycles showed NOR, and 75 cycles DOR. There were no significant differences between the DOR and NOR groups regarding intrauterine (74.7% vs. 83.4%, respectively) or chemical (14.7% vs. 14.1%, respectively) pregnancies. The DOR group had a higher EP than that of NOR group [10.7% (8/75) vs. 2.5% (9/355), p =0.004]. In both univariate [odds ratio (OR) 5.6, 95% confidence interval (CI) 1.4–9.6, p =0.011] and multivariate (adjusted OR 5.1, 95 % CI 1.1–18.7, p =0.012) analysis, DOR was associated with a higher risk of EP. Conclusion DOR may be associated with a higher risk of EP in IVF/ET cycles with controlled ovarian stimulation. More careful monitoring may be necessary for pregnant women with DOR.

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Section: Discussionsupporting

confidence: 92%

Correlation between Ovarian Reserve and Incidence of Ectopic Pregnancy afterIn VitroFertilization and Embryo Transfer

Kim

Shin

et al. 2019

Yonsei Med J

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“…2, where an infant with 10 months of age, scored 8 in social life ability scale). The median score of social maturity was 15 (range, [8][9][10][11][12][13][14][15][16][17][18][19].…”

Section: Resultsmentioning

confidence: 99%

“…Interestingly, we found an obviously increased occurrence of heterotopic interstitial pregnancy in patients with a history of pelvic inflammatory disease or tubal operation, which was consistent with previous report. 13 Therefore, the patients with the above risk factors who underwent ART should be cautious about the occurrence of HP.…”

Section: Discussionmentioning

confidence: 99%

The effect of local aspiration and methotrexate injection on live interstitial pregnancy coexisting with live intrauterine pregnancy after assisted reproductive technology

Yang

Zhu

Fang

et al. 2019

J of Obstet and Gynaecol

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Aim To share the experience of local aspiration and instillation of methotrexate (MTX) to selective reduction of live interstitial pregnancy and to evaluate its clinical effect and the outcome of intrauterine pregnancy. Methods Twelve patients with heterotopic interstitial pregnancy were enrolled at Women's Hospital, Zhejiang University School of Medicine, from 2006 to 2017. All the pregnancies were derived from assisted reproductive technology (ART). The transvaginal aspiration to interstitial pregnancy sac and local instillation of MTX (range from 12.5 to 30 mg) were performed for the patients under ultrasound‐guide. The prognosis and pregnancy outcomes were followed up. Results No severe side effects of medical treatment were observed in all patients. Three cases underwent subsequent laparotomy cornual resection, and no perioperative complications were found in these three patients. Twelve patients gave birth to 13 healthy infants without congenital anomalies. The average birth weight and gestational age was 2837 g (SD ± 605 g) and 36.8 weeks (SD ± 2.4 weeks). No growth anomalies and mental retardation were observed in live birth offspring. Conclusion The transvaginal ultrasound‐guided aspiration and injection of MTX might be a feasible alternative treatment for heterotopic interstitial pregnancy when vital signs of patients are stable.

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“…Most researchers thought the supra physiologic hormonal levels could confer a higher ectopic pregnancy rate with fresh ET cycles (34,35). However, Xiao et al found no signi cant difference in ectopic pregnancy rate between fresh ET and FET (36). Chen et al found there was higher pregnancy loss rate in the fresh ET group compared to FET group in ovulatory women (13).…”

Section: Discussionmentioning

confidence: 99%

Live Birth Rate of Fresh Embryo Transfer with GnRH Agonist Long Protocol is Higher Than Frozen Embryo Transfer

Ding

Yang

et al. 2020

Preprint

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Background: Along with progress in embryo cryopreservation, especially in vitrification has made freeze all strategy more acceptable. Some studies found comparable or higher live birth rate with frozen embryo transfer (FET) than with fresh embryo transfer（ET）in gonadotropin releasing hormone antagonist (GnRH-ant) protocol. But there were no reports about live birth rate differences between fresh ET and FET with gonadotropin releasing hormone agonist (GnRH-a) long protocol. The aim of this study is to analyze whether patients benefit from freeze all strategy in GnRH-a protocol from real-world data.Methods: This is a retrospective cohort study, in which women undergoing fresh ET or FET with GnRH-a long protocol at Chongqing Reproductive and Genetics Institute from January 2016 to December 2018 were evaluated. The primary outcome was live birth rate. The secondary outcomes were implantation rate, clinical pregnancy rate, pregnancy loss and ectopic pregnancy rate.Results: A total of 7,814 patients met inclusion criteria, implementing 5,216 fresh ET cycles and 2,598 FET cycles, respectively. The demographic characteristics of the patients were significantly different between two groups, except BMI. After controlling for a broad range of potential confounders (including age, infertility duration, BMI, AMH, no. of oocytes retrieved and no. of available embryos), multivariate logistic regression analysis demonstrated that there was no significant difference in terms of clinical pregnancy rate, ectopic pregnancy rate and pregnancy loss rate between two groups (all P>0.05). However, the implantation rate and live birth rate of fresh ET group were significantly higher than FET group (P<0.001 and P=0.012, respectively).Conclusion: Compared to FET, fresh ET following GnRH-a long protocol could lead to higher implantation rate and live birth rate in infertile patients underwent in vitro fertilization (IVF). The freeze all strategy should be individualized and made with caution especially with GnRH-a long protocol.

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

Cited by 22 publications

References 23 publications

Correlation between Ovarian Reserve and Incidence of Ectopic Pregnancy afterIn VitroFertilization and Embryo Transfer

Correlation between Ovarian Reserve and Incidence of Ectopic Pregnancy afterIn VitroFertilization and Embryo Transfer

The effect of local aspiration and methotrexate injection on live interstitial pregnancy coexisting with live intrauterine pregnancy after assisted reproductive technology

Live Birth Rate of Fresh Embryo Transfer with GnRH Agonist Long Protocol is Higher Than Frozen Embryo Transfer

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