scholarly journals Risk factors and pregnancy outcomes of heterotopic pregnancy secondary to in vitro fertilization-embryo transfer: A case series study

2020 ◽  
Author(s):  
Shaomi Zhu ◽  
Qinxiu Zhang ◽  
Linjiang Song
Keyword(s):  
Embryo Transfer ◽  
Pregnancy Outcomes ◽  
Case Series ◽  
Tubal Infertility ◽  
Vitro Fertilization ◽  
Operative Duration ◽  
History Of ◽  
Ectopic Pregnancies ◽  
Ivf Et

Abstract Background: The early diagnosis and treatment of heterotopic pregnancy (HP) remain one of the biggest challenges in the field of gynecology. A coexisting intrauterine gestation makes the ectopic pregnancy in HP more difficult to diagnose. This case series analysis is designed to explore factors affecting the incidence of HP secondary to in vitro fertilization-embryo transfer (IVF-ET) and that affecting pregnancy outcomes after surgical treatment of HP.Methods: From the IVF registry system, the clinical data of 29 patients with HP and 92 with an intrauterine-only pregnancy (IUP) following embryo transfer from January 2009 to December 2017 were retrospectively analyzed.Results HP had a higher proportion of previous ectopic pregnancies, multiple abortion history ( ≧ 2 times) and tubal indication for IVF than IUP. In patients with HP, 31.03% had spontaneous abortion, 25.00% had preterm delivery and 58.62% resulted in a live birth. According to the results from logistic regression, history of multiple abortions (odds ratio (OR) 3.031, 95% confidence intervals (CI) 1.087-8.453; P=0.034), tubal infertility (OR 3.844, 95% CI 1.268-11.656; P=0.017), previous ectopic pregnancies (OR 2.303, 95% CI 0.625-8.490; P=0.021) and multiple embryo transfer ( OR 0.300, 95% CI 0.092-0.983; P=0.037) resulted in an elevated proportion of HP in IVF cycles. Incidence of HP was comparable between patients transferred with blastocyst and cleavage embryos. Shorter operative duration, smaller size of the ectopic mass and location in the ampulla of the fallopian tube were associated with higher chance of survival in the coexistent intrauterine pregnancy after surgical treatment with HP.Conclusions:The early diagnosis of HP remains a challenge. Previous history of ectopic pregnancy, multiple abortions, tubal infertility and multiple embryo transfer may be considered as meaningful risk factors of subsequent HP following IVF-ET. In patients with HP treated by surgery, shorter operative duration, smaller size of the ectopic mass and location in the ampulla of the fallopian tube means better reproductive prognosis.

scholarly journals Acute Miliary Tuberculosis in Pregnancy After in Vitro Fertilization and Embryo Transfer: Report of Seven Cases and Systemic Review

2020 ◽  
Author(s):  
Xiaoyan Gai ◽  
Hongbin Chi ◽  
Wenli Cao ◽  
Lin Zeng ◽  
Lixue Chen ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Embryo Transfer ◽  
Pregnancy Outcomes ◽  
Miliary Tuberculosis ◽  
Systemic Review ◽  
Vitro Fertilization ◽  
Pulmonary Tb ◽  
In Pregnancy ◽  
Ivf Et

Abstract BackgroundWhile miliary tuberculosis (TB) in pregnancy is rare after in vitro fertilization and embryo transfer (IVF-ET), it poses a serious threat to the health of pregnant women and their fetuses. The present study aimed to describe the clinical features of miliary TB and pregnancy outcomes of patients after IVF-ET.MethodsData of infertile patients who received IVF-ET at Peking University Third Hospital between January 2012 to December 2017 were retrospectively analyzed. Patients who developed miliary TB during pregnancy were identified, and clinical characteristics of miliary TB were described. The keywords “infertility,” “in vitro fertilization and embryo transfer,” and “tuberculosis” were used to search for articles published from 1980 to 2019 in PubMed, Medline, and EMBASE databases.ResultsOf 62,755 enrolled women, 7137 (11.4%) showed signs of prior pulmonary TB on chest X-ray (CXR). Seven patients aged 28–35 years had miliary TB during pregnancy, with two patients complicated by TB meningitis. All of these patients presented with fever. Notably, old TB lesions were detected on CXR in six patients before IVF-ET; nevertheless, no anti-TB therapy was administered. Furthermore, salpingography revealed oviduct obstruction in all patients (7/7). Patients received anti-TB therapy following a diagnosis of miliary TB and were clinically cured. However, pregnancy was terminated due to spontaneous (4/7) and induced (3/7) abortion. Previous literature indicates that signs of prior TB on CXR and oviduct obstruction on laparoscopy are risk factors for TB reactivation during pregnancy, which displayed a trend for hematogenous dissemination.ConclusionsTB reactivation, mostly as miliary TB and TB meningitis, is severe in pregnant women after IVF-ET and deleterious to pregnancy outcomes. The coexistence of primary infertility, untreated prior pulmonary TB, and fallopian tube obstruction is a risk factor for TB dissemination.

scholarly journals Acute miliary tuberculosis in pregnancy after in vitro fertilization and embryo transfer: a report of seven cases

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaoyan Gai ◽  
Hongbin Chi ◽  
Wenli Cao ◽  
Lin Zeng ◽  
Lixue Chen ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Pregnant Women ◽  
Embryo Transfer ◽  
Pregnancy Outcomes ◽  
Miliary Tuberculosis ◽  
Vitro Fertilization ◽  
Peking University ◽  
In Pregnancy ◽  
Ivf Et

Abstract Background While miliary tuberculosis (TB) in pregnancy is rare after in vitro fertilization and embryo transfer (IVF-ET), it poses a serious threat to the health of pregnant women and their fetuses. The present study aimed to describe the clinical features of miliary TB and pregnancy outcomes of patients after IVF-ET. Methods Data of infertile patients who received IVF-ET at Peking University Third Hospital between January 2012 and December 2017 were retrospectively analyzed. Patients who developed miliary TB during pregnancy were identified, and clinical characteristics of miliary TB were described. Results Out of 62,755 infertile women enrolled, 7137 (11.4 %) showed signs of prior pulmonary TB on chest X-ray (CXR). Among the 15,136 women (mean age: 33.2 ± 5.0 years) who successfully achieved clinical pregnancy, seven patients aged 28–35 years had miliary TB during pregnancy, with two patients having a complication of TB meningitis. All these patients presented with fever. Notably, old TB lesions were detected on CXR in six patients before IVF-ET; nevertheless, no anti-TB therapy was administered. Furthermore, salpingography revealed oviduct obstruction in all patients (7/7). Patients received anti-TB therapy following a diagnosis of miliary TB and were clinically cured. However, pregnancy was terminated due to spontaneous (4/7) and induced (3/7) abortion. Conclusions TB reactivation, mostly as miliary TB and TB meningitis, is severe in pregnant women after IVF-ET and deleterious to pregnancy outcomes. Signs of prior TB on CXR may be risk factors for TB reactivation during pregnancy.

scholarly journals Acute miliary tuberculosis in pregnancy after in vitro fertilization and embryo transfer: A report of seven cases and systematic review

2020 ◽  
Author(s):  
Xiaoyan Gai ◽  
Hongbin Chi ◽  
Wenli Cao ◽  
Lin Zeng ◽  
Lixue Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Embryo Transfer ◽  
Pregnancy Outcomes ◽  
Miliary Tuberculosis ◽  
Vitro Fertilization ◽  
Pulmonary Tb ◽  
In Pregnancy ◽  
Ivf Et

Abstract Background: While miliary tuberculosis (TB) in pregnancy is rare after in vitro fertilization and embryo transfer (IVF-ET), it poses a serious threat to the health of pregnant women and their fetuses. The present study aimed to describe the clinical features of miliary TB and pregnancy outcomes of patients after IVF-ET.Methods: Data of infertile patients who received IVF-ET at Peking University Third Hospital between January 2012 to December 2017 were retrospectively analyzed. Patients who developed miliary TB during pregnancy were identified, and clinical characteristics of miliary TB were described. The keywords “infertility,” “in vitro fertilization and embryo transfer,” and “tuberculosis” were used to search for articles published from 1980 to 2019 in PubMed, MEDLINE, EMBASE, and Chinese Wanfang databases.Results: Of 62,755 enrolled women, 7,137 (11.4%) showed signs of prior pulmonary TB on chest X-ray (CXR). Seven patients aged 28–35 years had miliary TB during pregnancy, with two patients having a complication of TB meningitis. All of these patients presented with fever. Notably, old TB lesions were detected on CXR in six patients before IVF-ET; nevertheless, no anti-TB therapy was administered. Furthermore, salpingography revealed oviduct obstruction in all patients (7/7). Patients received anti-TB therapy following a diagnosis of miliary TB and were clinically cured. However, pregnancy was terminated due to spontaneous (4/7) and induced (3/7) abortion. Previous literature indicates that signs of prior TB on CXR and oviduct obstruction on laparoscopy are risk factors for TB reactivation during pregnancy, which displayed a trend for hematogenous dissemination.Conclusions: TB reactivation, mostly as miliary TB and TB meningitis, is severe in pregnant women after IVF-ET and deleterious to pregnancy outcomes. Physicians should not only enhance awareness about miliary TB, but also consider the occurrence of this form of TB, particularly in patients presenting with unknown fever as well as those in whom risk factors for TB reactivation such as primary infertility, untreated prior pulmonary TB, and fallopian tube obstruction coexist.

Salivary oestradiol and progesterone after in vitro fertilization and embryo transfer using different luteal support regimens

1990 ◽  
Vol 2 (4) ◽  
pp. 351 ◽  
Author(s):  
YF Wong ◽  
EP Loong ◽  
KR Mao ◽  
PP Tam ◽  
NS Panesar ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Embryo Transfer ◽  
Luteal Phase ◽  
Biologically Active ◽  
Luteal Support ◽  
Vitro Fertilization ◽  
Group A ◽  
Group B ◽  
Ivf Et

Salivary oestradiol (E2) and progesterone (P) levels have been shown to reflect the biologically active fractions in the serum. The luteal-phase status of stimulated cycles was investigated after in vitro fertilization and embryo transfer (IVF-ET). Thirty patients were randomly allocated to one of three luteal therapy groups: group A had no support, group B had intramuscular P and group C had intramuscular P and human chorionic gonadotrophin (hCG). One pregnancy was achieved in group A, two in group B and three in group C. Significant correlations between salivary and serum levels of E2 and of P in matched samples during luteal phase were found. Salivary E2 levels from luteal day 8 through day 14 and P levels from day 3 through day 14 were significantly higher in the pregnant than in the nonpregnant cycles. Among the nonpregnant cycles, salivary E2 and P levels were significantly higher in group C than in group A or B. These findings suggest that, in stimulated cycles for IVF-ET, determination of salivary E2 and P levels may be used as reliable alternatives to serum concentrations for assessing the luteal phase. Also, the additional hCG has an enhanced luteotrophic effect, as reflected by the higher salivary E2 and P levels, which may lead to a better pregnancy rate.

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