Risk of Ectopic Pregnancy in IVF
Risk of Ectopic Pregnancy in IVF; Pregnancy in which the fertilised embryo is implanted in any tissue other than the uterine lining 95% of ectopics occur in the tube, 1.5% abdominal, 0.5% ovarian and 0.03% cervix. Previous ectopic pregnancy is an important risk factor for another tuba pregnancy. For many women with a history of IVF and a history of 1 or more ectopic pregnancies, IVF will be the best option for having a baby. In IVF pregnancies, the risk of another ectopic is significantly reduced.
Pelvic inflammatory disease, PID
The rate of ectopic pregnancy in women with previously known PID is about 10 times higher than in women with no previous history of PID. A published study of 745 women with one or more PIDs who tried to get pregnant showed that 16% were infertile from blocked tubes. For those who did get pregnant, 6.4% had ectopic. Pelvic inflammatory disease is usually caused by invasion of gonorrhoea or chlamydia from the cervix to the uterus and tubes.
Risk of Ectopic Pregnancy in IVF; Infection in these tissues causes an intense inflammatory response. Bacteria, white blood cells and other fluids (pus) fill the tubes as the body fights the infection. Eventually the body wins and the bacteria are destroyed. However, during the healing process, the delicate inner linings of the tubes are permanently injured. The termination of the tube by the ovaries can become partially or completely blocked and scar tissue often forms on the outside of the tubes and ovaries.
All of these factors can affect ovarian or tubal function and the chances of successful pregnancy in the future. If pelvic inflammatory disease is treated early and aggressively with IV antibiotics, damage to the tube can be minimised and fertility preserved.
Risk of Ectopic Pregnancy in IVF
Other risk factors for ectopic pregnancies
Approximately 12% of pregnancies are ectopic after non-laparoscopic tubal ligation Approximately 50% of pregnancies are ectopic after laparoscopic tubal coagulation
- Previous tubal surgery
- Ovulation induction or ovarian stimulation
- IVF – In vitro fertilisation
Approximately 2% of IVF pregnancies are ectopic. It is higher in women with a history of thrombotic injury or previous ectopic pregnancy. Ectopic pregnancy is the leading cause of maternal morbidity and mortality in the first trimester and the incidence increases dramatically with in vitro fertilisation and embryo transfer (IVF-ET). The coexistence of an EP with a viable intrauterine pregnancy (IUP) is known as heterotopic pregnancy (HP), which affects approximately 1% of patients during assisted conception. EP/HP can cause significant morbidity and occasional mortality and represent diagnostic and therapeutic challenges, especially during fertility treatment. Many risk factors related to IVF-ET techniques and the cause of infertility have been documented.
Risk of Ectopic Pregnancy in IVF; The combination of transvaginal ultrasound (TVS) and serum human chorionic gonadotropin (hCG) is the most reliable diagnostic method with early EP/HP diagnosis allowing conservative treatment. This review describes the risk factors, diagnostic methods and treatment approaches of EP/HP during IVF-ET and its impact on subsequent fertility treatment.
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Risk of Ectopic Pregnancy in IVF
