Risk factors for ectopic pregnancy in assisted reproduction

Objective: To identify risk factors for ectopic pregnancy (EP) after IVF-ET . Design: Retrospective cohort study. Setting: In vitro fertilization clinic at a university hospital. Patient(s): A total of 725 women who conceived after IVF were studied with regard to background factors, indications for IVF, and factors related to t he IVF procedure through review of their medical charts. The rate of EP was 4%, corresponding with 29 EPs, of which 2 were heterotopic. Intervention(s): None. Main Outcome Measure(s): Pregnancy outcome, defined as intrauterine pregnan cy or EP, Background factors, indications for IVF, and factors related to t he IVF procedure were analyzed for possible correlation with the outcome of EP. Risk factors for EP were identified by logistic regression analysis. Result(s): Tubal factor infertility, various previous abdominal surgeries, previous EP or pelvic infection, presence of a hydrosalpinx or fibroid, and type of transfer catheter used showed a positive correlation with EP as ou tcome. Logistic regression analysis identified two factors with predictive power: tubal factor infertility and previous myomectomy. Conclusion(s): Tubal factor infertility was the most prominent risk factor for EP lifter IVF. Previous myomectomy appeared to be another important ris k factor, but this is a new finding that needs to be confirmed by further s tudy. (Fertil Steril(R) 1999,71:282-6. (C) 1999 by American Society for Rep roductive Medicine.).