Yonsei Med J.  2019 Mar;60(3):285-290. 10.3349/ymj.2019.60.3.285.

Correlation between Ovarian Reserve and Incidence of Ectopic Pregnancy after In Vitro Fertilization and Embryo Transfer

• Kim SW
• Kim YJ
• Shin JH
• Kim H
• Ku SY
• Suh CS
• Kim SH
• Choi YM

• KMID: 2441306
• DOI: http://doi.org/10.3349/ymj.2019.60.3.285

Abstract

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.

Keyword

Anti-Müllerian hormone; follicle stimulating hormone; ectopic pregnancy; in vitro fertilization; ovarian stimulation

MeSH Terms

Chorionic Gonadotropin
Embryo Transfer*
Embryonic Structures*
Female
Fertilization in Vitro*
Follicle Stimulating Hormone
Humans
In Vitro Techniques*
Incidence*
Infertility
Observational Study
Oocyte Retrieval
Oocytes
Ovarian Reserve*
Ovulation Induction
Pregnancy
Pregnancy Outcome
Pregnancy, Ectopic*
Pregnant Women
Chorionic Gonadotropin
Follicle Stimulating Hormone

Figure

• 

  Fig. 1 Comparison of pregnancy outcomes between DOR and NOR. DOR, decreased ovarian reserve; NOR, normal ovarian reserve; CP, chemical pregnancy; IUP, intrauterine pregnancy; EP, ectopic pregnancy.

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