Effect of endometrial preparation protocols on the risk of ectopic pregnancy for frozen embryo transfer

Abstract

Studies have consistently reported a significantly reduced incidence of ectopic pregnancy (EP) for frozen-thawed embryo transfer (ET) cycles compared with fresh cycles. However, only a few studies reported an association between endometrial preparation protocols on EP and results were conflicting. A registry-based retrospective cohort study of 153,354 clinical pregnancies following frozen single ETs between 2014 and 2017 were conducted, of which 792 cases of EP (0.52%) were reported. Blastocyst embryo transfers accounted for 87% of the total sample and were significantly associated with a decreased risk for EP compared with early cleavage ET (0.90% vs. 0.46%, adjusted OR = 0.50, 95% CI, 0.41 to 0.60). Compared with natural cycles, hormone replacement cycles (HRC) demonstrated a similar risk for EP (0.53% vs. 0.47%, adjusted OR = 1.12, 95% CI, 0.89 to 1.42). Subgroup analysis with or without tubal factor infertility and early cleavage/blastocyst ETs demonstrated similar non-significant associations. Endometrial preparation protocols using clomiphene (CC) were associated with a significantly increased risk for EP (1.12%, adjusted OR = 2.34; 95% CI, 1.38 to 3.98). These findings suggest that HRC and natural cycles had a similar risk for EP. Endometrial preparation using CC was associated with an increased risk of EP in frozen embryo transfer cycles.

Effect of endometrial thickness on the risk of ectopic pregnancy for frozen embryo transfer

“…Many researchers believe that EP is associated with ovarian stimulation. However, our results showed similar EP rates in hormone replacement cycles (HRT) compared with natural cycles, which is consistent with Jwa et al .’s findings [26] . The inconsistencies among the findings of these studies need to be validated in prospective multicenter trials.…”

Rectal ectopic pregnancy after in vitro fertilization and embryo transfer: A case report

“…[ 1 ] With the development of assisted reproductive technology (ART), the incidence of ectopic pregnancy after in vitro fertilization (IVF) is 3.4%, which is significantly higher than that in vivo conception. [ 2 , 3 ] Abdominal pregnancy is a rare kind of ectopic pregnancy, and it can be suspected based upon an elevated serum β-human chorionic gonadotropin (β-hCG) level in combination with ultrasound findings showing absence of an intrauterine gestational sac and a wide mobility similar to fluctuation of the sac. [ 4 ] Unlike the positive initial serum β-hCG of the usual abdominal pregnancy following IVF, this case report a ruptured rectal ectopic pregnancy with an inappropriate rise of serum β-hCG.…”