HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Clayton, H. B. Articles by Wright, V. C. Search for Related Content PubMed PubMed Citation Articles by Clayton, H. B. Articles by Wright, V. C.

Ectopic Pregnancy Risk With Assisted Reproductive Technology Procedures

From the ¹Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; and ²Departments of Maternal and Child Health and Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

OBJECTIVE: To assess the ectopic pregnancy risk among women who conceived with assisted reproductive technology (ART) procedures.

METHODS: The ectopic rate for ART pregnancies was calculated from population-based data of pregnancies conceived with ART in U.S. clinics in 1999–2001. Variation in ectopic risk by patient and ART treatment factors was assessed by using bivariate analyses and multivariable logistic regression.

RESULTS: Of 94,118 ART pregnancies, 2,009 (2.1%) were ectopic. Variation was observed by procedure type. In comparison with the ectopic rate (2.2%) among pregnancies conceived with in vitro fertilization and transcervical transfer of freshly fertilized embryos from the patient’s oocytes (fresh, nondonor IVF-ET), the ectopic rate was significantly increased when zygote intrafallopian transfer (ZIFT) was used (3.6%) and significantly decreased when donor oocytes were used (1.4%) or when a gestational surrogate carried the pregnancy (0.9%). Among fresh nondonor IVF-ET procedures, the risk for ectopic pregnancy was increased among women with tubal factor infertility (odds ratio [OR] 2.0, 95% confidence interval [CI] 1.7–2.4; referent group = ART for male factor), endometriosis (OR 1.3, 95% CI 1.0–1.6), and other nontubal female factors of infertility (OR 1.4, 95% CI 1.2–1.6) and decreased among women with a previous live birth (OR 0.6, 95% CI 0.5–0.7). Transfer of embryos with an indication of high implantation potential was associated with a decreased ectopic risk when 2 or fewer embryos were transferred (OR 0.7, 95% CI 0.5–0.9), but not when 3 or more embryos were transferred.

CONCLUSION: Ectopic risk among ART pregnancies varied according to ART procedure type, reproductive health characteristics of the woman carrying the pregnancy, and estimated embryo implantation potential.

LEVEL OF EVIDENCE: II-2

This article has been cited by other articles:

				A. Revel, I. Ophir, M. Koler, H. Achache, and D. Prus Changing etiology of tubal pregnancy following IVF Hum. Reprod., June 1, 2008; 23(6): 1372 - 1376. [Abstract] [Full Text] [PDF]