Abdominal ectopic pregnancy after in vitro fertilization and single embryo transfer: a case report and systematic review
| Autor: | Reshef Tal, J. Ryan Martin, Nicole Yoder |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Infertility
Adult Male medicine.medical_specialty Ectopic pregnancy medicine.medical_treatment Endometriosis IVF-ET Fertilization in Vitro Review 03 medical and health sciences 0302 clinical medicine Endocrinology Pregnancy Risk Factors In vitro fertilization Pregnancy Abdominal Single Embryo Transfer Medicine Humans 030212 general & internal medicine Infertility Male Unexplained infertility Abdominal pregnancy Gynecology 030219 obstetrics & reproductive medicine In vitro fertilisation business.industry Obstetrics Obstetrics and Gynecology Tubal factor infertility medicine.disease Pregnancy Ectopic Reproductive Medicine Female Laparoscopy business Developmental Biology |
| Zdroj: | Reproductive Biology and Endocrinology : RB&E |
| ISSN: | 1477-7827 |
| Popis: | Background Ectopic pregnancy is the leading cause of maternal morbidity and mortality during the first trimester and the incidence increases dramatically with assisted-reproductive technology (ART), occurring in approximately 1.5–2.1 % of patients undergoing in-vitro fertilization (IVF). Abdominal ectopic pregnancy is a rare yet clinically significant form of ectopic pregnancy due to potentially high maternal morbidity. While risk factors for ectopic pregnancy after IVF have been studied, very little is known about risk factors specific for abdominal ectopic pregnancy. We present a case of a 30 year-old woman who had an abdominal ectopic pregnancy following IVF and elective single embryo transfer, which was diagnosed and managed by laparoscopy. We performed a systematic literature search to identify case reports of abdominal or heterotopic abdominal ectopic pregnancies after IVF. A total of 28 cases were identified. Results Patients’ ages ranged from 23 to 38 (Mean 33.2, S.D. = 3.2). Infertility causes included tubal factor (46 %), endometriosis (14 %), male factor (14 %), pelvic adhesive disease (7 %), structural/DES exposure (7 %), and unexplained infertility (14 %). A history of ectopic pregnancy was identified in 39 % of cases. A history of tubal surgery was identified in 50 % of cases, 32 % cases having had bilateral salpingectomy. Transfer of two embryos or more (79 %) and fresh embryo transfer (71 %) were reported in the majority of cases. Heterotopic abdominal pregnancy occurred in 46 % of cases while 54 % were abdominal ectopic pregnancies. Conclusions Our systematic review has revealed several trends in reported cases of abdominal ectopic pregnancy after IVF including tubal factor infertility, history of tubal ectopic and tubal surgery, higher number of embryos transferred, and fresh embryo transfers. These are consistent with known risk factors for ectopic pregnancy following IVF. Further research focusing on more homogenous population may help in better characterizing this rare IVF complication and its risks. |
| Databáze: | OpenAIRE |
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