Ectopic Pregnancy History as an Independent Factor Associated with Recurring Ectopic Pregnancy in Women with Bilateral Salpingectomies. A Matched-Pair Study of IVF Patients

Abstract

Background: The incidence of ectopic pregnancy (EP) is purportedly elevated among individuals with a history of EP (referred to as the EP group) compared to those with no previous ectopic pregnancy (non-EP group). Nevertheless, the question of whether an EP history represents an autonomous risk factor for subsequent ectopic pregnancy of in vitro fertilization-embryo transfer (IVF-ET) patients remains a subject of debate. Methods: This study is a retrospective cohort study conducted at a single center. A total of sixty-seven patients with a prior ectopic pregnancy (EP) who underwent bilateral salpingectomy were included, and they were age-matched with a control group of 201 patients who did not have a history of EP but underwent bilateral salpingectomy during the period from January 2011 to April 2017. In all cases, laparoscopic salpingectomy was performed, followed by subsequent IVF-ET and frozen-thawed embryo transfer (FET) cycles. Results: The cumulative clinical pregnancy rates in the EP group and non-EP group were 65.7% and 73.6%, respectively, demonstrating no significant difference. Likewise, the cumulative live birth rates between the two groups were comparable (50.7% in the EP group vs. 63.6% in the non-EP group, p = 0.2). However, the incidence of ectopic pregnancy was significantly higher in the EP group compared to the non-EP group (15.9% vs. 3.4%, p = 0.003). Subsequent regression analyses revealed a significant association between a history of EP and an elevated risk of ectopic pregnancy. Conclusions: Women with a history of ectopic pregnancy even if they have had bilateral salpingectomies are at a significantly higher risk of subsequent ectopic pregnancies, indicating that a prior ectopic pregnancy is an independent risk factor for this condition, even if fallopian tubes have been removed.