Dubuisson J B, Aubriot F X, Mathieu L, Foulot H, Mandelbrot L, de Jolière J B
Service de Gynécologie-Obstétrique, Clinique Universitaire Port-Royal, Paris, France.
Fertil Steril. 1991 Oct;56(4):686-90. doi: 10.1016/s0015-0282(16)54600-7.
To analyze risk factors for ectopic pregnancy (EP) after in vitro fertilization (IVF).
A retrospective study of IVF pregnancies was performed between November 1983 and December 1989.
This study was conducted in a tertiary care center, the Port-Royal University Hospital.
Patients' records were reviewed for 48 EP and 508 intrauterine pregnancies obtained by IVF.
Forty-six salpingectomies were performed for EP after IVF.
We evaluated the impact on the ectopic rate of tubal status, the type of ovarian stimulation and luteal phase support, and the number of embryos transferred.
Forty-three of 48 EP occurred in patients with tubal infertility. The rate of EP was significantly higher when the indication was tubal (11.1%) than when it was endometriosis (2.1%) or unexplained infertility (3.4%). Pathological findings revealed tubal lesions in all 46 salpingectomies.
Ectopic pregnancy after IVF appears related to pre-existing tubal pathology. However, routine prophylactic salpingectomy to prevent the risk of EP does not appear justified.
分析体外受精（IVF）后异位妊娠（EP）的危险因素。
对1983年11月至1989年12月期间的IVF妊娠进行回顾性研究。
本研究在三级医疗中心皇家港大学医院进行。
回顾了48例IVF后发生的EP患者及508例IVF后宫内妊娠患者的记录。
对46例IVF后发生EP的患者实施了输卵管切除术。
我们评估了输卵管状况、卵巢刺激类型和黄体期支持以及移植胚胎数量对异位妊娠率的影响。
48例EP中有43例发生在输卵管性不孕患者中。当指征为输卵管因素时EP发生率（11.1%）显著高于子宫内膜异位症（2.1%）或不明原因不孕（3.4%）时。病理检查结果显示46例输卵管切除标本均有输卵管病变。
IVF后异位妊娠似乎与既往存在的输卵管病变有关。然而，常规预防性输卵管切除术以预防EP风险似乎并无必要。
