Effect of treatment of a previous ectopic pregnancy on in vitro fertilization intracytoplasmic sperm injection outcomes A retrospective cohort study

Capsule:
This retrospective cohort study demonstrates that a history of ectopic pregnancy carries a higher risk of recurrent ectopic pregnancy after in vitro fertilization– intracytoplasmic sperm injection.

Authors:
Zhen Xu, M.D., Lei Yan, M.D., Ph.D., Wen Liu, M.D., Xinxin Xu, M.D., Miao Li, M.D., Lingling Ding, M.D., Jinlong Ma, M.D., Ph.D., Zi-Jiang Chen, M.D., Ph.D.

Volume 104, Issue 106, Pages 1446-1451

Abstract:

Objective:
To evaluate the influence of previous ectopic pregnancies (EP) and different EP treatment methods on in vitro fertilization–intracytoplasmic sperm injection (IVF-ICSI) outcomes.

Design:
Retrospective cohort study.

Setting:
University-based reproductive medicine center.

Patient(s):
Women undergoing 51,268 fresh cycles of IVF-ICSI.

Intervention(s):
In women who had had an EP before the IVF treatment and women who were diagnosed with fallopian disease without an EP (control group), division into three treatment subgroups: subgroup 1, conservative treatment; subgroup 2, salpingostomy; and subgroup 3 salpingectomy.

Main Outcome Measure(s):
Estimates of IVF-ICSI outcome and ovarian function based on number of antral follicles and rates of implantation, EP, clinical pregnancy, and delivery.

Result(s):
For the experimental group and the control group, there were no statistically significant differences in the rates of implantation, clinical pregnancy, or delivery. However, the risk of recurrent EP was statistically significantly higher in the experimental group compared with the control group. There were no statistically significant differences in IVF-ICSI outcomes between the three treatment subgroups in terms of the basic antral follicle number or the dominant antral follicle numbers (>1.0 cm) after surgical treatment of EP.

Conclusion(s):
Our results suggest that women with a prior history of EP have a higher recurrence risk of EP after IVF in comparison with women with no history of EP. Previous EP has no effect on the main IVF-ICSI outcomes. For the treatment of EP, salpingostomy and salpingectomy do not statistically significantly affect ovarian function.

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