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The risk of ectopic pregnancy following tubal reconstructive microsurgery and assisted reproductive technology procedures

  • Reproductive Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

The incidence of ectopic pregnancy (EP) in the general population is 2%, whereas the EP rate following assisted reproductive technologies (ART) is between 2.1 and 11%. EP is also an adverse effect of tubal surgery with incidences up to 40% depending on the type, location, and severity of tubal disease and the surgical procedure.

Methods

This paper looks at the incidence of EP following tubal reconstructive microsurgery, analyzes risk factors for EP following own 1,295 ART cycles and looks on the incidence of EP in 128,314 pregnancies following ART according to the presence or absence of tubal infertility using data from the German IVF Registry (DIR).

Results

In our clinic, the EP rate following resterilization was 6.7%. In the presence of acquired tubal disease, the EP rate following adhesiolysis, salpingostomy, salpingoneostomy, fimbrioplasty, and anastomosis was 7.9%. The EP rate following ART in our clinic was 5.6%. Previous abdominal surgeries, microsurgical procedures, hydro-/sactosalpinges, salpingitis, salpingitis isthmica nodosa, and periadnexal adhesions showed a significant positive correlation with EP as outcome. Data of DIR demonstrate a significantly increased incidence of EP in the presence of tubal pathology. The highest EP rate related to all clinical pregnancies was 4.5% (95% CI 3.0–6.0) in smoking women <30 years with tubal pathology following IVF.

Conclusions

In the presence of tubal infertility, the incidence of EP following ART and tubal microsurgery are approximately comparable with each other and higher than in women without tubal infertility. The success of infertility surgery depends on a careful selection of appropriate patients.

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Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Division of Reproductive Medicine, Department of Gynecology and Obstetrics, Medical School of Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Germany

    Cordula Schippert, Philipp Soergel, Ismini Staboulidou, Christina Bassler, Susanne Gagalick, Peter Hillemanns & Guillermo-José Garcia-Rocha

  2. German IVF-Registry, DIR Committee’s Offices, c/o Chamber of Physicians of Schleswig-Holstein, Bismarckallee 8-12, 23795, Bad Segeberg, Germany

    Klaus Buehler

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  1. Cordula Schippert
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  2. Philipp Soergel
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  3. Ismini Staboulidou
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  4. Christina Bassler
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  8. Guillermo-José Garcia-Rocha
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Correspondence to Cordula Schippert.

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Schippert, C., Soergel, P., Staboulidou, I. et al. The risk of ectopic pregnancy following tubal reconstructive microsurgery and assisted reproductive technology procedures. Arch Gynecol Obstet 285, 863–871 (2012). https://doi.org/10.1007/s00404-011-2092-6

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  • DOI: https://doi.org/10.1007/s00404-011-2092-6

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