Blastocyst transfer and ectopic pregnancy

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The objective of this retrospective study is to evaluate the effect of transferring vitrified blastocysts on the rate of ectopic pregnancy (PE).

We analyzed the patients included in the Japanese registry of assisted reproduction since 2008. We analyzed the rate of healthy newborn, PE (ectopic pregnancy) and spontaneous abortion in single blastocysts.

In single transfers of vitrified blastocysts there were 84 EPs of 10,312 clinical pregnancies (0.81%). In single transfers of fresh blastocysts by IVF there were 25 EPs of 1,361 (1.8%) and 19 EPs of 1,352 (1.4%) in transfers with fresh blastocysts obtained by ICSI .

In conclusion, the transfer of vitrified blastocysts significantly reduces the rate of ectopic pregnancy compared with the transfer of fresh blastocysts.

Below you have an index with all the points that we will discuss in this article.

Index

Introduction

An ectopic pregnancy after performing some technique of assisted reproduction is a complication with serious consequences for the patient.

There are studies that show a higher incidence (2.2% to 4.5%) of EPs in pregnancies achieved by ART compared to spontaneous pregnancies. Other studies show an incidence of up to 8.6%. However, it is difficult to assess the rate of EPs by transfer since the number of embryos transferred is variable.

The incidence of EPs with vitri-devitrified embryos is also variable. According to a recent study, this rate is higher in frozen embryos than in fresh embryos but without statistical differences.

This study examines the effect of vitri-devitrified embryo transfers on the incidence of PE and spontaneous abortion in patients where only a single embryo is transferred (single embryo transfers).

Risk of ectopic pregnancy

Material and methods

The data has been obtained from the Japanese registry on assisted reproduction techniques. This record includes data on cycles performed, stimulation protocols used, rates of clinical pregnancy with evidence of embryo sac, the number of embryos transferred and whether they are fresh or frozen.

Our study includes patients who have undergone IVF, ICSI, and frozen embryo transfer.

Results

In 2008, 603 Japanese clinics out of a total of 609 offered their data in the registry of the Japan Obstetrics and Gynecology Society. The total annual cycles of IVF, ICSI and frozen embryo transfer were 57,719, 71,350 and 58,646 respectively, of which a single transfer was made in 17,626 IVF cycles, 20,290 ICSI cycles and 38,389 frozen embryo transfers.

A total of 20,866 clinical pregnancies were achieved, the rate of live newborns per clinical pregnancy was 69-75% depending on the treatment. The rate of ectopic pregnancy (PE) was significantly lower in single transfers of frozen embryos than in single transfers of fresh embryos.

Bibliography

Ishihara O, Kuwahara A, Saitoh H. Frozen-thawed blastocyst transfer reduces ectopic pregnancy risk: an analysis of single embryo transfer cycles in Japan. Fertil Steril. 2011; 95 (6): 1966-9.

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