ANALYSIS OF THE INCIDENCE AND RISK-FACTORS ASSOCIATED WITH ECTOPIC PREGNANCY FOLLOWING IN-VITRO FERTILIZATION AND EMBRYO-TRANSFER

Ectopic pregnancy is a well known complication of in-vitro fertilizati on (IVF) and embryo transfer, From March 1983 to December 1993, 3000 c linical pregnancies were achieved at Bourn Hall Clinic, including 135 ectopic pregnancies (4.5%), Of these ectopics 20 were heterotopic, eig ht ovarian, six bilateral tubal and the remainder were singleton tubal pregnancies. The main risk factor identified in the series was a hist ory of pelvic inflammatory disease (P < 0.001), The data also showed t hat ectopic pregnancy is at present more prevalent among patients in w hom tubal damage is the reason for treatment, There was slight statist ical evidence (P = 0.05) that patients having ectopic pregnancies rece ived a higher volume of culture medium than those having normal delive ries. There was also an apparent trend (P = 0.07, not significant) tha t high progesterone/oestradiol ratio on the day of embryo transfer was associated with ectopic pregnancy, There was no statistical evidence of association between ectopic pregnancy and a history of ectopic preg nancy, abortion, still birth, termination of pregnancy, neonatal death , tubal surgery, ovarian stimulation protocol, plasma concentration of oestradiol, luteinizing hormone and progesterone, number of oocytes r etrieved, number or quality of embryos transferred, administration of general anaesthesia for embryo transfer, and the number of patent Fall opian tubes. Awareness of the risk factors associated with ectopic pre gnancy plays an important part in the early diagnosis of this potentia lly fatal condition.