The clinical pregnancy rate, miscarriage rate, and live birth rates of the two groups were not significantly different.
Additionally, the frequency of recurrent EP following IVF was not affected by the use of salpingostomy or salpingectomy treatments for EP.
Retrospective cohort study included all women who received IVF/intracytoplasmic sperm inject (ICSI), treatments at the Reproductive Medicine Center Sir Run Shaw Hospital in Hangzhou, China between January 2016 – May 2020.
The study divided the women into three groups: 457 with a history or recurrent EP (the REP), 912 with a single EP history (the SEP group), and 1,169 with a history intrauterine pregnancy (the IUP) group.
The incidence of EP after IVF treatment in the REP group was significantly lower than that in the SEP groups: 2.4% vs. 7.8%P = 0.011).
The prevalence of EP in REP was comparable to IUP: 2.4% vs..2.1%P = 0.830).
There were also no statistically significant differences between the three groups in terms of clinical pregnancy rate, miscarriage rates and live birth rate.
Women with previous REP had lower live birth rates than women with IUP and women with SEP.
The odds of EP were 82.2% higher in women who had blastocyst transfers than cleavage embryo transfers in the SEP group: odds ratio (OR = 0.178) 95% confidence interval (9CI): 0.042-0.762 (P = 0.20)
The odds of EP were six times higher in women who received double embryo transfer than in those who received one embryo transfer in IUP. OR = 6.260; 95%CI : 1.255 to 31.212 (P = 0.025).
“Our study is valuable because this is the first to provide evidence for the effect of a history of recurrent EP on outcomes of subsequent IVF treatment,” wrote the authors. “This is also the largest study of a population with previous recurrent EP.”
The validity of the study’s data is enhanced by the clinical and laboratory protocols from a single center, such as ovarian stimulation, embryo transfer technique, embryo culture system, embryo cryopreservation and thaw protocols.
The authors speculate that repeated surgical treatments for EPs might reduce the chance of developing it.
Further, the study revealed that women who had a single EP were more likely to experience infertility than those with recurrent EP. “This implies that a long attempt time to pregnant may play a role in the etiology of EP occurrence,” wrote the authors.
Women with tubal EP may choose surgery to repair damaged tubes. This can alter the embryo-tubal transport system and lead to an increase in recurrent EP.
Xue Y, Tong X, Zhang H, et al. In vitro fertilization in women who have had recurrent ectopic pregnancies. PLoS ONE. 17(8):e0272949. doi:.org/10.1371/journal.pone.0272949
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