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[Tubal abnormalities: predisposing factor for extrauterine pregnancy in in-vitro fertilization]
1Academisch Ziekenhuis, afd. Obstetrie en Gynaecologie, Groningen.
Objective:
Determination of the difference in percentages of ectopic pregnancies in patients with and without tubal pathology after in-vitro fertilisation and consequences for prevention.
Setting:
Thirteen IVF clinics in the Netherlands.
Method:
The clinics submitted data on clinical and ectopic pregnancies and the indication for IVF from the years 1990 and 1991.
Results:
The indication in 1075 cases of IVF-clinical pregnancies was a tubal factor and in 990 cases of IVF-clinical pregnancies another (non-tubal) factor. Percentages of ectopic pregnancies in these groups were 4.5 and 1.1 respectively (significant difference: relative risk: 4.02; 95% confidence interval: 2.10-7.69). One case of heterotopic pregnancy had occurred. No particular type of tubal pathology with high risk for ectopic pregnancy could be identified.
Conclusion:
Preventive salpingectomy before the IVF procedure in patients with a tubal factor is not justified.