Risk factors for ectopic pregnancy in 556 pregnancies after in vitro fertilization: implications for preventive management.
OBJECTIVE
To analyze risk factors for ectopic pregnancy (EP) after in vitro fertilization (IVF).


METHODS
A retrospective study of IVF pregnancies was performed between November 1983 and December 1989.


METHODS
This study was conducted in a tertiary care center, the Port-Royal University Hospital.


METHODS
Patients' records were reviewed for 48 EP and 508 intrauterine pregnancies obtained by IVF.


METHODS
Forty-six salpingectomies were performed for EP after IVF.


METHODS
We evaluated the impact on the ectopic rate of tubal status, the type of ovarian stimulation and luteal phase support, and the number of embryos transferred.


RESULTS
Forty-three of 48 EP occurred in patients with tubal infertility. The rate of EP was significantly higher when the indication was tubal (11.1%) than when it was endometriosis (2.1%) or unexplained infertility (3.4%). Pathological findings revealed tubal lesions in all 46 salpingectomies.


CONCLUSIONS
Ectopic pregnancy after IVF appears related to pre-existing tubal pathology. However, routine prophylactic salpingectomy to prevent the risk of EP does not appear justified.
Service de Gynécologie-Obstétrique, Clinique Universitaire Port-Royal, Paris, France.
J B
JB
Dubuisson
F X
FX
Aubriot
L
L
Mathieu
H
H
Foulot
L
L
Mandelbrot
J B
JB
de Jolière
D000328:Adult; D004624:Embryo Transfer; D004958:Estradiol / Q000097:blood; D005184:Fallopian Tube Diseases / Q000150:complications / Q000601:surgery; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D005307:Fertilization in Vitro; D007987:Gonadotropin-Releasing Hormone / Q000627:therapeutic use; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000628:therapy; D008596:Menotropins / Q000627:therapeutic use; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000209:etiology / Q000517:prevention & control* / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors
D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol; D008596:Menotropins