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Human Reproduction Update, Vol.6, No.1 pp.80-92, 2000
© European Society of Human Reproduction and Embryology 2000; all rights reserved

Extra-uterine pregnancy following assisted conception treatment

N. Abusheikhacfafcfje, O. Salhacfaddcdj,1 and P. Brinsdencfafcfje

cfafcfje Bourn Hall Clinic, Bourn, Cambridge, and cfaddcdj Assisted Conception Unit, St James’s University Hospital, Leeds, UK

Received on February 15, 1999; accepted on November 22, 1999

Abstract

Ectopic pregnancy may be the only life-threatening disease in which prevalence has increased as mortality has declined. The most prominent theory to explain this phenomenon involves increased sensitivity of serum -human chorionic gonadotrophin (HCG) immunoassay and improved quality of transvaginal ultrasound, combined with a heightened awareness and increased suspicion of the condition among clinicians which has allowed early detection of ectopic pregnancy. Laparotomy, once the standard treatment of ectopic pregnancy, has been replaced almost entirely by operative laparoscopy. This is associated with a shorter hospital stay, fewer post-operative analgesic requirements, reduced costs and lower risk of adhesion formation. Laparotomy, however, remains necessary in cases with haemodynamic instability and with exceptional locations, e.g. cervical, abdominal and interstitial implantation. In selected cases, non-surgical management has also obtained high success rates. Among medical therapies, the most common is systemic or local administration of methotrexate. The other option is expectant management involving follow-up using serial serum HCG measurements and ultrasound scans. Thus, life-threatening ectopic pregnancy is now evolving into a medical disease, with the possibility of lower-cost treatment, faster recovery and higher subsequent fertility. In this review we assess the risk of extra-uterine implantation after assisted conception treatment, the accuracy of various diagnostic tools and focus on the efficacy, safety and the fertility outcomes of surgical and non-surgical management of ectopic pregnancy.

Key words: assisted conception/ / diagnosis/ / ectopic/ / management


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 Hum Reprod UpdateHome page
H. Fernandez and A. Gervaise
Ectopic pregnancies after infertility treatment: modern diagnosis and therapeutic strategy
Hum. Reprod. Update, November 1, 2004; 10(6): 503 - 513.
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