Tubal factor infertility with prior ectopic pregnancy: a double whammy? A retrospective cohort study of 2,892 women

Prior tubal ectopic pregnancy does not increase the probability of adverse fertility outcomes in in vitro fertilization treatment, which will help clinicians to counsel infertile women with an ectopic first pregnancy.

Like Comment
Related Content

Volume 113, Issue 5, Pages 1032–1038

Authors:

He Cai, M.D., Ben W. Mol, M.D., Ph.D., Ping Li, M.D., Xitong Liu, M.D., Antoine Watrelot, M.D., Juanzi Shi, M.D., Ph.D.

Abstract:

Objective

To investigate the impact of a history of previous naturally conceived tubal ectopic pregnancy (TEP) on subsequent IVF/intracytoplasmic sperm injection (ICSI) pregnancy and perinatal outcomes.

Design

Retrospective cohort study.

Setting

Reproductive medicine center in a tertiary hospital.

Patient(s)

A total of 2,892 women with tubal infertility undergoing the first fresh IVF/ICSI cycle.

Intervention(s)

Women were stratified into three groups according to the type of previous naturally conceived pregnancy: TEP, intrauterine pregnancy (IUP), and no pregnancy.

Main Outcomes Measure(s)

Pregnancy and neonatal outcomes were analyzed for each cohort and stratified into the following categories based on female age: <30 years, 30–35 years, and ≥35 years.

Result(s)

Of the 2,892 patients with tubal factor infertility, 511 (17.7%) women had a history of TEP, 1,044 (36.1%) had prior IUP, and 1,337 (46.2%) had never been pregnant. Couples with an initial TEP tended to be younger and had experienced a shorter duration of infertility. Across the whole cohort, the optimal live birth rate decreased in older age groups. Live birth rates stratified by maternal age (<30, 30–35, ≥35 years) did not differ between the TEP group (59.9%, 53.7%, 45.5%) and the IUP (62.0%, 53.8%, 40.6%) and no pregnancy group (56.7%, 54.4%, 45.6%). This did not change after adjusting for confounders such as age and years of infertility. Previous treatment of TEP with salpingectomy, salpingostomy, or medical treatment did not significantly affect subsequent fertility outcomes. The rates of preterm and low birth weight after TEP were also not significantly higher than in women with a previous IUP.

Conclusion(s)

Fertility history, including previous TEP, does not influence the probability of live birth after IVF/ICSI in women with tubal factor infertility.


Read the full text here.

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

No comments yet.