Ectopic pregnancy risk factors for ART patients undergoing the GnRH antagonist protocol: a retrospective study

Reproductive Biology and Endocrinology

Research

R. Beck-Fruchter¹  Y. Geslevich¹  J. Golan¹  M. Lavee¹  E. Shalev²  A. Weiss² 

[1] Department of Obstetrics and Gynecology, Emek Medical Center, Afula, Israel;Department of Obstetrics and Gynecology, Emek Medical Center, Afula, Israel;Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel;

关键词: In-vitro fertilization;    GnRH agonist trigger;    Ectopic pregnancy;    Oocyte maturation;   

DOI  :  10.1186/s12958-016-0146-0

 received in 2015-12-11, accepted in 2016-03-02,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundIn-vitro fertilization is a known risk factor for ectopic pregnancies. We sought to establish the risk factors for ectopic pregnancy in GnRH antagonist cycles examining patient and stimulation parameters with an emphasis on ovulation trigger.MethodsWe conducted a retrospective, cohort study of 343 patients undergoing 380 assisted reproductive technology (ART) cycles with the GnRH antagonist protocol and achieving a clinical pregnancy from November 2010 through December 2015.ResultsSignificant risk factors for ectopic pregnancy in the univariate analysis included prior Cesarean section (CS), endometriosis, mechanical factor infertility, longer stimulation, elevated estradiol and progesterone levels, GnRH agonist trigger, higher number of oocytes aspirated, and insemination technique. Independent risk factors for ectopic pregnancy in the multivariate analysis included GnRH agonist trigger, higher number of oocytes aspirated, insemination technique, and prior Cesarean section.ConclusionExcessive ovarian response, IVF (as opposed to ICSI), prior Cesarean section and GnRH agonist trigger were found to be independent risk factors for ectopic pregnancy. Caution should be exercised before incorporating the GnRH agonist trigger for indications other than preventing OHSS. When excessive ovarian response leads to utilization of GnRH agonist trigger, strategies for preventing ectopic pregnancy, such as a freeze all policy or blastocyst transfer, should be considered. Further studies should elucidate whether adjusting the luteal support can reduce the ectopic pregnancy risk.

【 授权许可】

CC BY   
© Weiss et al. 2016