Ectopic pregnancy following in vitro fertilisation and embryo transfer.

BACKGROUND

ectopic pregnancy is one of the recognised complications of in vitro fertilisation (IVF) and embryo transfer.

OBJECTIVE

to review cases of ectopic pregnancy following IVF at a fertility unit, with the aim of raising awareness towards its increased incidence and pattern of presentation.

METHODS

case records of patients who had ectopic pregnancy following IVF over a three-year-period (July 2005-June 2008) were retrieved from the medical records department. Data including age, parity, risk factors for ectopic pregnancy as well as management modality were extracted and analysed.

RESULTS

There were 64 clinical pregnancies during the study period. Of these, five were ectopic pregnancies, given a frequency of 7.8%. The minimum number of embryos transferred was two and maximum four. All the five cases had easy embryo transfer. There was one case of heterotopic pregnancy. Two (40%) patients had previous ectopic pregnancies with one having a third ectopic pregnancy despite previous bilateral salpingectomies. Four (80%) of the five cases had laparotomy done. Three (60%) cases had ruptured ectopic pregnancies. One case was managed conservatively with methotrexate.

CONCLUSION

ectopic pregnancy can present following IVF procedures. A high index of suspicion is necessary even in cases with previous bilateral salpingectomies or easy embryo transfer.