What are the risks for ectopic pregnancy?

What are the risks for ectopic pregnancy?

Up to 50 % of women diagnosed with ectopic disease don’t have any risk factors. However, few of the conditions increasing the risk for ectopic gestation are:

• Previous ectopic pregnancy
• Tubal damage from infection or surgery
• History of infertility
• Therapy for in vitro fertilization
• Increased age
• Smoking
• Prior pelvic infection
• DES exposure
• IUD use
• Pregnancy conceived by assisted reproduction.

Is IVF a risk for ectopic pregnancy?

Risk of EP is more in women undergoing IVF treatment. This may be due to:

• The reproductive and medical characteristics of the woman
• Embryo quality and implantation potential
• A history of infertility in relation to age and duration
• Tubal factor infertility is associated with a two-fold risk of EP following IVF

Assisted reproductive technologies constitute a risk factor for EP, as 2–5 % of pregnancies from assisted reproductive technologies are ectopic. 

Following are the factors contributing to this increased risk:  

• Cycles triggered with gonadotropin releasing hormone (GnRH) agonists may have high risk of EP due to poor endometrial receptivity
• The more number of embryos, more the EP risk
• Transfer of embryo in mid cavity is safer than a fundal transfer
• The transfer of fresh embryos is associated with a higher EP risk than cryopreserved cycle due to hyperstimulation and hyperestrogenic environment affecting receptivity.