Exploration Of High-risk Factors Of Ectopic Pregnancy In Vitro Fertilization And Embryo Transfer

ObjectTo explore the prevalence rate, risk factors,diagnosis,treatment,prognosis and prevention of ectopic pregnancy(EP) after in vitro fertilization and embryo transfer (IVF-ET).MethodsThe clinical data of 93 cases ectopic pregnancy patients(EP group) and 116 cases single hysterocyesis patients after IVF or intracytoplasmic sperm injection(ICSI)-ET during July 2005 to November 2010 in the Sir Run Run Shaw Hospital of Zhejiang University College of Medicine were reviewed. Compared with the patient's age, infertility time, previous oviduct disease,previous ectopic pregnancy, previous abortion history, previous pelvic surgery history, fertilization methods, the egg number, excellent embryo rate, the endometrium thickness, the estrogen and progesterone level on the day of HCG(human chorionic gonadotropin) injected, the number of embryos transferred, the distance from the top of the transplant tube to the bottom of the uterine cavity,the blood serum P-HCG value of the first 12 day after embryo transfer,frozen embryo transfer cycle and fresh embryo transfer cycle (referred to as frozen cycle and fresh cycle) situations between two groups.Statistical methodsThe data was analyzed by SPSS 13.0 for windows.Comparison of the average in the two groups was performed by t-test, X2 test compared the differences about counting data. P< 0.05 shows the statistical difference.ResultAmong the total 6116 clinical pregnancies after 3183 cycle of IVF or (ICSI)-ET during July 2005 to November 2010 in the Sir Run Run Shaw Hospital, there are 93 cases of EP,(2.92%,93/3183).Of these EP, there were 70 cases belonging to tubal pregnancies(75.27%,70/93),6 cases of uterine angle pregnancies(6.45%),1 case of cervix pregnancy(2.15%),14 cases of heterotopic pregnancies(15.05%),1 case of intra-abdominal pregnancy(2.15%).80 cases of EP group (80/93) with oviduct complete or incomplete obstruction verified by HSG or laparoscopic exploration are obvious more than 78 cases of control group(78/116), (P<0.05). The EP group's estrogen and progesterone level on the day of HCG injected are both more than the control group's. About the comparison of the blood serumβ-HCG value of the first 12 day after embryo transfer, HP group's (340±241) IU/L is significantly higher than the control group's (214±103) IU/L (P<0.05),the control group's is significantly higher than the extrauterine pregnancy'(115±71)IU/L (P< 0.05). The clinical pregnancy rate of frozen cycle59.39%(1588/2674) is higher than the fresh cycle' 46.34%(1595/3442) (P< 0.05) during July 2005 to November 2010.The EP rate of frozen cycle 1.95%(31/1588) is lower than the fresh cycle's 3.89%(62/1595) (P< 0.05)ConclusionPrevious oviduct disease is the main high-risk factor for EP after ectopic pregnancy in vitro fertilization and embryo transfer. The high estrogen and progesterone level on the day of HCG injected infects endometrial receptivity and oviduct function. The clinical pregnancy rate of the frozen cycle is higher than the fresh cycle's. The EP rate of the frozen cycle is lower than the fresh cycle's.