Department of Obstetrics and Gynecology, Assisted Reproduction Unit, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Department of Obstetrics and Gynecology, Key Laboratory of Reproductive Dysfunction Management of Zhejiang Province, Hangzhou, China.
PLoS One. 2022 Aug 15;17(8):e0272949. doi: 10.1371/journal.pone.0272949. eCollection 2022.
The aim of this study was to investigate the impact of a history of recurrent ectopic pregnancy (EP) on pregnancy outcomes of subsequent in vitro fertilization (IVF) treatment.
A retrospective cohort study involving 457 women with a history of recurrent EP (REP group), 912 women with a history of single EP (SEP group), and 1169 women with a history of intrauterine pregnancy (IUP group) as the control group, was conducted. IVF outcomes were compared for each cohort.
The incidence of EP in the REP group after IVF treatment was significantly lower than those in the SEP group (2.4% vs. 6.8%, P = 0.011), and similar to those in the IUP group (2.4% vs. 2.1%, P = 0.830). No significant differences were observed in the clinical pregnancy rate, miscarriage rate, and live birth rate among the three groups. There was no statistically significant difference in the recurrent EP rate between the salpingectomy and salpingostomy treatments. Adjusting for maternal and treatment factors did not influence live birth rates for women with previous REP compared with women with previous SEP and those with IUP. The odds of EP were 82.2% lower (OR 0.178, 95% CI 0.042-0.762; P = 0.020) in women who had blastocyst transfer compared with cleavage embryo transfer in the SEP group. The odds of EP were over six times (OR 6.260, 95% CI 1.255-31.220; P = 0.025) in women who underwent double embryo transfer as opposed to single embryo transfer in the IUP group.
Our results indicate that women with previous recurrent EP have a lower risk of EP after IVF in comparison with women with previous single EP. Previous EP has no significant adverse effect on the main IVF outcomes. The salpingostomy and salpingectomy treatments of EP do not significantly affect the incidence of recurrent EP after IVF.
本研究旨在探讨复发性宫外孕（EP）病史对后续体外受精（IVF）治疗妊娠结局的影响。
进行了一项回顾性队列研究，共纳入 457 例有复发性 EP 病史的妇女（REP 组）、912 例有单次 EP 病史的妇女（SEP 组）和 1169 例有宫内妊娠病史的妇女（IUP 组）作为对照组。比较了每个队列的 IVF 结局。
REP 组 IVF 治疗后 EP 的发生率明显低于 SEP 组（2.4%比 6.8%，P=0.011），与 IUP 组相似（2.4%比 2.1%，P=0.830）。三组间临床妊娠率、流产率和活产率无显著差异。输卵管切除术和输卵管造口术治疗的复发性 EP 发生率无统计学差异。调整了母体和治疗因素后，与 SEP 组和 IUP 组相比，既往有 REP 的妇女活产率没有差异。与 SEP 组中卵裂期胚胎转移相比，囊胚转移的 EP 发生几率降低了 82.2%（OR 0.178，95%CI 0.042-0.762；P=0.020）。与 IUP 组中单胚胎移植相比，双胚胎移植的 EP 发生几率增加了 6 倍以上（OR 6.260，95%CI 1.255-31.220；P=0.025）。
与既往有单次 EP 病史的妇女相比，既往有复发性 EP 病史的妇女在 IVF 后发生 EP 的风险较低。既往 EP 对 IVF 的主要结局无显著不良影响。EP 的输卵管造口术和切除术治疗对 IVF 后复发性 EP 的发生率无显著影响。
