Risk factors for ectopic pregnancy after fresh non-donor in vitro fertilization and embryo transfer

Lyu, Sang Woo; Won, Hyung Jae; Yoon, Tae Ki; Lee, Woo Sik; Kawk, In Pyung; Cho, Jung Hyun; Han, Ji Eun; Kim, Soo Hee; Kim, You Shin; Seok, Hyun Ha

Abstract

OBJECTIVE
To find risk factors for ectopic pregnancy among women who conceived after fresh non-donor in vitro fertilization and embryo transfer (IVF-ET).
METHODS
A total of 2,326 cycles conceived after fresh non-donor IVF-ET between January 2002 and December 2005 were studied with regard to patient factors, and factors related to the ART procedures through review of their medical chart. Risk factors in ectopic pregnancy were assessed by using chi-square test and multivariate logistic regression analysis.
RESULTS
Of 2,326 pregnancies of fresh non-donor IVF-ET cycles, 135 (5.8%) were ectopic pregnancies. Most of ectopic pregnancies were tubal type (79 cases, 58.5%) and combined type (40 cases, 29.6%). Most of ectopic pregnancies (87.4%) were treated by laparoscopic surgery. In comparison with clinical pregnancy group, estradiol level checked on human chorionic gonadotrophin (hCG) injection day for final follicular maturation and mean number of oocytes retrived were higher in ectopic group. respectively, (2,228.9 vs. 1,906.9 pg/ml, p=0.022; 13.8 vs. 11.6, p=0.001). In univariate analysis, the risk for ectopic pregnancy was increased among women with tubal factor infertility (odds ratio [OR] 1.7, 95% confidence interval [CI] 1.20-2.35) and, decreased among women with male factor infertility (OR 0.7, 95% CI 0.47-0.94) and use of intracytoplasmic sperm injection (ICSI) (OR 0.7, 95% CI 0.50-0.98). However, in multivariate logistic regression analysis, only tubal factor was an independent predictor for ectopic pregnancy.
CONCLUSIONS
Tubal factor infertility is the main risk factor for ectopic pregnancy following fresh non-donor IVF-ET.