Risk factors and pregnancy outcomes of intrauterine pregnancy with tubal pregnancy after IVF/ICSI
10.3760/cma.j.cn101441-20230428-00177
- VernacularTitle:IVF/ICSI助孕宫内合并输卵管妊娠的风险因素及妊娠结局分析
- Author:
Dingran WANG
1
;
Yan YANG
1
;
Jiajia ZHANG
1
;
Xueling SONG
1
;
Caihong MA
1
;
Shuo YANG
1
;
Rong LI
1
Author Information
1. 北京大学第三医院妇产科生殖医学中心 国家妇产疾病临床医学研究中心（北京大学第三医院）辅助生殖教育部重点实验室（北京大学）北京市生殖内分泌与辅助生殖技术重点实验室，北京 100191
- Publication Type:Journal Article
- Keywords:
Fertilization in vitro;
Embryo transfer;
Pregnancy, heterotopic;
Live birth;
Hydrosalpinx
- From:
Chinese Journal of Reproduction and Contraception
2024;44(2):179-183
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the risk factors, pregnancy outcomes of intrauterine pregnancy with tubal pregnancy after in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). Methods:The study was a retrospective case-control study that collected clinical data of patients diagnosed with intrauterine combined with tubal pregnancy after IVF/ICSI for infertility at Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital from January 2009 to December 2021. The study group consisted of patients diagnosed with intrauterine combined with tubal pregnancy after IVF/ICSI and treated with surgery ( n=91). The control group consisted of patients diagnosed with early intrauterine pregnancy after IVF/ICSI in a 1∶4 ratio during the same period ( n=364). General information, assisted reproduction and pregnancy-related data of the two groups were analyzed, and risk factors for intrauterine combined with tubal pregnancy after IVF/ICSI were determined through univariate and logistic analyses. Furthermore, the study group was divided into two subgroups according to different pregnancy outcomes, miscarriage and live birth, and risk factors that may affect pregnancy outcomes of patients with intrauterine combined with tubal pregnancy were analyzed between the two subgroups. Results:There were no significant differences in age, body mass index, gestational times, basal hormone levels, endometrial thickness before transplantation and human chorionic gonadotropin level after transplantation between the study group and control group (all P>0.05). The live birth rate of the two groups was similar ( P>0.05). A history of ectopic pregnancy ( OR=2.605, 95% CI: 1.352-5.016, P=0.004) and hydrosalpinx ( OR=26.012, 95% CI: 2.942-229.974, P=0.003) were risk factors for intrauterine combined with tubal pregnancy after IVF/ICSI. Patients with intrauterine combined with tubal pregnancy were divided into live birth subgroup and abortion subgroup. There were no significant differences in the proportion of abdominal pain, uterine hemoperitoneum and other symptoms between the two subgroups (all P>0.05), and there were no statistical differences in operation time, gestational age and intraperitoneal hemorrhage between the two subgroups (all P>0.05). Vaginal bleeding after transplantation ( OR=3.128, 95% CI: 1.067-9.172, P=0.038) in the abortion subgroup may be a risk factor for miscarriage in intrauterine combined with tubal pregnancy. Conclusion:Live birth rate in intrauterine pregnancy combined with tubal pregnancy patients after surgery was similar with patients with normal intrauterine pregnancy. Ectopic pregnancy history and hydrosalpinx may be risk factors for patients with intrauterine pregnancy combined with tubal pregnancy after IVF/ICSI, and vaginal bleeding after transplantation may be a high risk factor for abortion in those patients.
