OBJECTIVE: To investigate the occurrence of ectopic pregnancy among women who received in vitro fertilization and assess the influential factors. METHODS: The indications, methods of assisted conception and ectopic types were analyzed retrospectively after the patients received in vitro fertilization and embryo transfer (IVF-ET), intracytoplasmic sperm injection (ICSI), or freezing-thawing embryo transfer (FET). RESULTS: A total of 6007 embryo transfers were performed, and 2322 (38.7%) clinical pregnancies were obtained. Ninety-four (4.05%) of them were ectopic pregnancies; and 92 were tubal pregnancies. The occurrence rate was 3.96%, which constituted 97.87% (92/94) of all ectopic pregnancies. There were 2 cases of other parts: one in abdominal cavity and the other in cornual pregnancy with the occurrence rate of 0.86%, constituting 2.32% (2/94). Twenty heterotopic pregnancies occurred (0.86%), constituting 21.28% (20/94). Among all ectopic pregnancies, the assisted conception of 86 cases was tubal pathology and/or pelvic adherence (91.49%), and 24 patients had a history of ectopic pregnancy (25.53%). The differences of clinical pregnancy rates between IVF-ET, ICSI and FET were not significant (P>0.05). The ectopic rate of IVF-ET group was significantly higher than that of ICSI or FET group (P<0.05), respectively. The ectopic rate in FET group was also higher than that in ICSI group (P<0.05). CONCLUSION The occurrence rate of ectopic pregnancy after IVF is higher than that of spontaneous pregnancy, and the main cause for ectopic pregnancy is the tubal pathological changes.
Adult ; China ; epidemiology ; Embryo Transfer ; adverse effects ; Female ; Fertilization in Vitro ; adverse effects ; Humans ; Infertility, Female ; Middle Aged ; Pregnancy ; Pregnancy, Ectopic ; epidemiology ; etiology ; Retrospective Studies ; Sperm Injections, Intracytoplasmic

Intrauterine device (IUD) is a safe and efficient method of contraception in comparison with the efficacy of tubal sterilization, yet remains underutilized due to biased or outdated information about IUD. It is currently believed that the mechanism of action for IUDs is the production of an intrauterine environment that is spermicidal. IUD does not increase a woman's risk for pelvic infection, ectopic pregnancy, or subsequent infertility. IUD insertion in nulliparous or unmarried women is not contra-indicated. IUD is also a useful contraceptive method for those women without increasing the risk of ascending pelvic infection. The other benefit of IUD beyond contraception includes lowering the risk of endometrial cancer. The levonorgestrel-releasing intrauterine system reduces massive menstrual bleeding and dysmenorrhea. The copper IUD is the most effective method for emergency contraception. The careful patient selection and pre-insertion counseling are crucial to the success of IUD.
Bias (Epidemiology) ; Contraception ; Contraception, Postcoital ; Copper ; Counseling ; Dysmenorrhea ; Endometrial Neoplasms ; Female ; Hemorrhage ; Humans ; Infertility ; Intrauterine Devices ; Levonorgestrel ; Patient Selection ; Pelvic Infection ; Pregnancy ; Pregnancy, Ectopic ; Single Person ; Sterilization, Tubal

The objective of this study is to describe the clinical outcomes of patients treated for cervical pregnancy with or without methotrexate (MTX) and to evaluate the effects of MTX in the treatment of cervical pregnancy. Between January 1993 and February 2000, 31 patients were diagnosed with cervical pregnancy. Twenty-two patients were treated with MTX chemotherapy and nine patients were treated with surgical procedures without MTX treatment. In the non-MTX treatment group, three patients underwent total abdominal hysterectomy, five required adjuvant procedures to control the bleeding during dilatation and curettage (D&C) and only one patient was treated with a simple D&C. In the MTX treatment group, fourteen (63.6%) patients were treated with only MTX and eight (36.4%) cases underwent concomitant procedures (simple curettage, curettage and Foley catheter tamponade, cer-vical cerclage, ligation of the descending branches of uterine arteries, or ligation of hypogastric arteries). The uterus was preserved in all cases and three women delivered healthy babies in their subsequent pregnancy. In conclusion, early diagnosis, appropriate MTX regimen in combination of necessary adjuvant conservative procedures could contribute to successful treatment with preservation of the uterus and future reproductive ability.
Abortifacient Agents, Nonsteroidal/administration & dosage ; Comparative Study ; Dilatation and Curettage/*statistics & numerical data ; Female ; Humans ; Incidence ; Korea/epidemiology ; Methotrexate/*administration & dosage ; Pregnancy ; Pregnancy, Ectopic/*drug therapy/epidemiology/*surgery ; Retrospective Studies ; Risk Assessment/*methods ; Risk Factors ; Treatment Outcome

OBJECTIVETo investigate the correlation of the fertilization strategy and embryo transfer (ET) time with the incidence of ectopic pregnancy.

METHODSWe selected 3,331 fresh and 2,706 frozen-thawed ET cycles for the patients undergoing in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). The fresh transfers included 2 546 IVF-ET and 785 ICSI-ET cycles and 2,220 day-3 embryo and 1,111 day-5 blastocyst transfers, while the frozen-thawed transfers included 2,080 IVF-ET and 626 ICSI-ET cycles and 741 day-3 embryo and 1 965 day-5 or -6 blastocyst transfers. We compared the incidence rate of ectopic pregnancy associated with different fertilization strategies and ET time.

RESULTSThe incidence rate of ectopic pregnancy was 1. 41% (36/2 546) in the IVF-ET cycles and 3.44% (27/785) in the ICSI-ET cycles of the fresh transfers, significantly lower in the IVF-ET than in the ICSI-ET cycles (P < 0.01), and it was 1.01% (21/2,080) in the IVF-ET cycles and 0.80% (5/626) in the ICSI-ET cycles of the frozen-thawed transfers, with no remarkable difference between the two groups (P > 0.05). The IVF-ET and ICSI-ET cycles included 2,220 fresh day-3 (F-D3) embryos, 1,111 F-D5 blastocysts, 741 frozen-thawed day-3 (T-D3) embryos, and 1,965 T-D5/6 blastocysts. The incidence rate of ectopic pregnancy was 1.71% (n = 38) in the F-D3, 2.25% (n = 25) in the F-D5, 1.35% (n = 10) in the T-D3, and 0.81% (n = 16) in the T-D5/6 group, respectively, significantly lower in the T-D5/6 than in the other three groups (P < 0.05).

CONCLUSIONThe incidence rate of ectopic pregnancy is associated with fertilization strategies, which is significantly lower in frozen-thawed than in fresh embryo transfers.

Blastocyst ; Embryo Transfer ; adverse effects ; methods ; statistics & numerical data ; Female ; Fertilization in Vitro ; adverse effects ; methods ; statistics & numerical data ; Humans ; Incidence ; Pregnancy ; Pregnancy Rate ; Pregnancy, Ectopic ; epidemiology ; etiology ; Sperm Injections, Intracytoplasmic ; adverse effects ; methods ; statistics & numerical data

OBJECTIVE: To investigate the role of previous gynecologic surgery, hormone use, and use of non-steroidal anti-inflammatory drugs on the risk of type 1 and type 2 ovarian cancer. METHODS: We utilized data collected for the Prostate, Lung, Colorectal, and Ovarian cancer screening trial. All diagnosed ovarian cancers were divided into three groups: type 1, endometrioid, clear cell, mucinous, low grade serous, and low grade adenocarcinoma/not otherwise specified (NOS); type 2, high grade serous, undifferentiated, carcinosarcoma, and high grade adenocarcinoma/NOS; and other: adenocarcinoma with grade or histology not specified, borderline tumors, granulosa cell tumors. The odds ratios for type 1, type 2, and other ovarian cancers were assessed with regard to historical information for specific risk factors. RESULTS: Ibuprofen use was associated with a decrease in risk for type 1 ovarian cancer. Tubal ligation and oral contraceptive use were associated with a decrease in risk for type 2 ovarian cancer. A history of ectopic pregnancy was associated with a decreased risk for all ovarian cancers by almost 70%. CONCLUSION: These findings support the hypothesis that carcinogenic pathways for type 1 and type 2 ovarian cancer are different and distinct. The marked reduction in all ovarian cancer risk noted with a history of ectopic pregnancy and salpingectomy implies that the fallopian tube plays a key role in carcinogenesis for both type 1 and type 2 ovarian cancer.
Aged ; Anti-Inflammatory Agents, Non-Steroidal/adverse effects ; Contraceptives, Oral, Hormonal/adverse effects ; *Early Detection of Cancer ; Female ; Gynecologic Surgical Procedures/adverse effects ; Humans ; Ibuprofen/adverse effects ; Middle Aged ; Ovarian Neoplasms/chemically induced/diagnosis/*etiology/pathology ; Pregnancy ; Pregnancy, Ectopic/epidemiology ; Risk Factors ; Surveys and Questionnaires