Ectopic pregnancy, though rare, poses a significant risk to women receiving fertility treatment. Although the aim of in-vitro fertilisation (IVF) is to increase the likelihood of a healthy intrauterine pregnancy, implantation can sometimes take place outside the uterus, most frequently in the fallopian tube. It is important to be aware of the risks, preventive measures and reasons related to ectopic pregnancy.
Why ectopic pregnancy occurs in IVF
An embryo passes through the fallopian tube and implants in the uterus during a natural conception. Through IVF embryo transfer, the embryo is planted into the uterus, avoiding the tubes completely. Yet, about one to two percent of IVF cycles can still result in an ectopic pregnancy. In rare instances, the embryo may implant in the cervix, ovary, or abdominal cavity, or it may move back into the fallopian tube from the uterus.
In patients undergoing IVF, a number of factors may increase the risk of an ectopic pregnancy:
- Tubal damage or previous ectopic pregnancy: Women who have had tubal surgery in the past, pelvic inflammatory disease, or previous ectopic pregnancies especially are more vulnerable because damaged tubes can make embryos to lodge outside the uterus.
- Hydrosalpinx (fluid-filled tube): A buildup of fluid in the fallopian tube may stimulate embryo migration or interfere with implantation.
- Difficult embryo transfers: An embryo may be pushed towards the tubes by uterine contractions triggered by a technically difficult transfer.
- Abnormally shaped or dilated tubes: Such structural problems create an environment that is favourable to non-uterine implantation.
Prevention Techniques
To lower the risk of an ectopic pregnancy, modern fertility clinics combine cutting-edge technology with clinical procedures. Although there is no guaranteed method, these actions greatly reduce the risk.
- Thorough pre-IVF evaluation
A thorough reproductive evaluation prior to IVF helps in the early detection of tubal issues. Hydrosalpinx or tubal scarring can be detected by laparoscopy, hysterosalpingography (HSG), or ultrasound. In order to reduce the risk of ectopic pregnancy and implantation failure, fertility experts may advise removing or cutting the damaged tube prior to the IVF procedure in case of substantial damage.
- Enhanced embryo transfer method
An important factor is the actual IVF embryo transfer procedure. To guarantee accurate embryo placement in the mid-uterine cavity, experts employ soft catheters and ultrasound guidance. This method has been shown to alleviate uterine contractions and enhance results. Avoiding deep placement, minimising cervical manipulation, and using a gentle transfer technique, all reduce the likelihood of embryo migration.
- Single embryo transfer (SET)
Transferring a single, high-quality embryo at a time lowers the risk of an ectopic implantation as well as the likelihood of multiple pregnancies. Fertility doctors are able to choose the healthiest embryo for SET with confidence, thanks to embryo grading and genetic testing (PGT-A).
- Handling hydrosalpinx prior to IVF
It is crucial to treat any hydrosalpinx found, prior to an IVF cycle. Both implantation and live birth rates are increased when the damaged tube is surgically removed or laparoscopically clipped to stop toxic fluid from leaking into the uterus.
- Close observation following transfer
For safety and detection, early monitoring is essential. Following IVF, rising but unusually slow hCG levels could indicate an ectopic pregnancy. Clinicians can quickly confirm intrauterine implantation with early ultrasounds performed at five to six weeks. Treatment for an ectopic pregnancy is safer and more successful the sooner it is detected.
Preventive measures taken by patients
Patients can actively help in managing the chances of risk, although majority of prevention measures are clinical. Here’s how:
- Describe your entire medical and surgical background.
- Do not miss any planned blood tests and ultrasounds.
- Report any symptoms like dizziness, spotting, shoulder pain, or sharp abdominal pain.
- Choose a fertility center known for meticulous embryo transfer protocols and expertise.
Conclusion
Although ectopic pregnancies in IVF are rare, prevention and awareness are crucial. Fertility experts can minimise risks and maximise the likelihood of a healthy pregnancy with improvements in tubal assessment, improved embryo transfer methods, and a personalised treatment planning. At luma, we ensure patients are empowered by knowledge, and safer, more successful outcomes in IVF are made possible by well-informed decisions.
Get in touch with us if you’re thinking about IVF or are worried about an ectopic pregnancy. You can pursue your goals with clarity and confidence with the support of professional advice, thorough screening, and individualised care.
