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

  • Monika Weigert
  • Diego Gruber
  • Elisabeth Pernicka
  • Peter Bauer
  • Wilfried Feichtinger
ASSISTED REPRODUCTION

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.

Keywords

Ectopic pregnancy  IVF-ET Assisted reproduction Tubal surgery Pregnancy rate 

References

  1. 1.
    Katz E, Akman M, et al. Deleterious effect of the presence of hydrosalpinx on implantations and pregnancy rates with in vitro fertilization. Fertil Steril 1996;66:122–5.PubMedGoogle Scholar
  2. 2.
    Cohen M, Lindheim S, et al. Hydrosalpinges adversely affect implanation in donor oocyte cycles. Hum Reprod Engl 1999;14(4):1087–9. doi: 10.1093/humrep/14.4.1087.CrossRefGoogle Scholar
  3. 3.
    Camus E, Poncelet C, et al. Pregnancy rates after in vitro fertilization in cases of tubal infertility with and without hydrosalpinx: a meta-analysis of published comparative studies. Hum Reprod 1999;4(5):1243–9. doi: 10.1093/humrep/14.5.1243GB.CrossRefGoogle Scholar
  4. 4.
    Ankum W, Mol B, et al. Risk factors for ectopic pregnancy, a meta-analysis. Fertil Steril 1996;65(6):1093–9.PubMedGoogle Scholar
  5. 5.
    Parazzini F, Tozzi L, et al. Risk factors of ectopic pregnancy: An Italian case control study. J Obstet Gyn 1992;80(5):821–6.Google Scholar
  6. 6.
    Coste J, Job-Spira N, Fernandez H. Increased risk of ectopic pregancy with maternal cigarette smoking. Am J Public Health 1991;81(2):199–201.PubMedCrossRefGoogle Scholar
  7. 7.
    Zouves C, Erenus M, et al. Ectopic pregnancy after in vitro fertilization and embryo transfer: a role for proximal occlusion or salpingectomy after failed distal tubal surgery? Fertil Steril 1991;56(4):691–5.PubMedGoogle Scholar
  8. 8.
    Dubuisson J, Aubriot F, et al. Risk factors of ectopic pregnancy in 556 pregnancies after in vitro fertilization: implications for preventive management. Fertil Steril 1991;56(4):686–90.PubMedGoogle Scholar
  9. 9.
    Clayton H, Schieve L, Peterson H, Jamieson D, Reynolds M, Wright V. Ectopic Pregnancy Risk With Assisted Reproductive Technology Procedures. Obstet Gynecol 2006;107(3):595–604.PubMedGoogle Scholar
  10. 10.
    Kemeter P, Feichtinger W. Experience with a new fixed-stimulation protocol without hormone determinations for programmed oozyte retrieval for IVF. Hum Reprod 1989;4:53–8.PubMedGoogle Scholar
  11. 11.
    Macnamee C, Howles C, et al. Short luteinizing hormone- releasing agonist treatment: prospective trial of a novel ovarian stimulation regimen for in- vitro fertilization. Fert Ster. 1989;89–92.Google Scholar
  12. 12.
    Tan S, Kingsland C, et al. The long protocol of administration of gonadotropin—releasing hormone agonist is superior to the short protocol for ovarian stimulation for in- vitro fertilization. Fertil Steril 1992;57:810–4.PubMedGoogle Scholar
  13. 13.
    Deutsches IVF-Register; Jahresbericht 2006, p12Google Scholar
  14. 14.
    Clayton H, Schieve L, et al. Ectopic Pregnancy Risk With Assisted Reproductive Technology Procedures. Obstet Gynecol 2006;107(3):595–604.PubMedGoogle Scholar
  15. 15.
    Qublan H, Malkawi H, et al. In-vitro fertilisation treatment: factors affecting its results and outcome. J Obstet Gynaecol 2005;25(7):689–93. doi: 10.1080/01443610500292353.PubMedCrossRefGoogle Scholar
  16. 16.
    Verhulst G, Camus M, et al. Analysis of risk factors with regard to the occurrence of ectopic pregnancy after medically assisted procreation. Hum Reprod 1993;8(8):1284–7.PubMedGoogle Scholar
  17. 17.
    Serour G, Aboulghar M, et al. Complications of medically assisted conception in 3.500 cycles. Fertil Ster USA 1998;70(4):638–42. doi: 10.1016/S0015-0282(98)00250-7.CrossRefGoogle Scholar
  18. 18.
    Hajenius P, Mol F, et al. Interventions for tubal ectopic pregnancy. Cochrane Database Syst Rev 2007. (1):CD000324.PubMedGoogle Scholar
  19. 19.
    Bulletti C. de Ziegler; Uterine contractility and embryo implantation. Curr Opin Obstet Gynecol 2005;17(3):265–76. doi: 10.1097/01.gco.0000169104.85128.0e, Review.PubMedCrossRefGoogle Scholar
  20. 20.
    Lyons R, Saridogan E, et al. The effect of ovarian follicular fluid and peritoneal fluid on Fallopian tube ciliary beat frequency. Hum Reprod 2006;21(1):52–6. doi: 10.1093/humrep/dei306.PubMedCrossRefGoogle Scholar
  21. 21.
    Lyons RA, Djahanbakhch O, et al. Peritoneal fluid, endometriosis, and ciliary beat frequency in the human fallopian tube. Lancet 2002;360(9341):1221–2. doi: 10.1016/S0140-6736(02)11247-5.PubMedCrossRefGoogle Scholar
  22. 22.
    Feichtinger W, Papalambrou K, et al. Smoking and In Vitro Fertilization: A Meta-Analysis. J Assist Reprod Genet 1997;14:596–9. doi: 10.1023/A:1022584802711.PubMedCrossRefGoogle Scholar
  23. 23.
    Agarwal S, Wisot A, et al. Cornual pregnancies in patients with prior salpingectomy undergoing IVF-ET. Fertil Steril 1996;65(3):659–60.PubMedGoogle Scholar
  24. 24.
    Nazari A, Askari H, et al. Embryo transfer technique as a cause of ectopic pregnancy in In- vitro fertilization. Fertil Steril 1993;60(5):919–21.PubMedGoogle Scholar
  25. 25.
    Pope C, Cook E, et al. Influence of embryo transfer depth on in vitro fertilization and embryo transfer outcomes. Fertil Steril 2004;81(1):51–8. doi: 10.1016/j.fertnstert.2003.05.030.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Monika Weigert
    • 1
    • 3
  • Diego Gruber
    • 2
  • Elisabeth Pernicka
    • 2
  • Peter Bauer
    • 2
  • Wilfried Feichtinger
    • 1
  1. 1.WunschbabyzentrumViennaAustria
  2. 2.Section of Medical Statistics, Core Unit for Medical Statistics and InformaticsMedical University of ViennaViennaAustria
  3. 3.ViennaAustria

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