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KMID : 0311120190600030285
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Yonsei Medical Journal
2019 Volume.60 No. 3 p.285 ~ p.290
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Correlation between Ovarian Reserve and Incidence of Ectopic Pregnancy after In Vitro Fertilization and Embryo Transfer
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Kim Sung-Woo
Kim Yong-Jin
Shin Jung-Ho
Kim Hoon
Ku Seung-Yup
Suh Chang-Suk
Kim Seok-Hyun
Choi Young-Min
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Abstract
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Purpose: To elucidate the correlation between ovarian reserve and the incidence of ectopic pregnancy (EP) following in vitro fertilization and embryo transfer (IVF/ET) cycles.
Materials and Methods: In this observational study, 430 fresh IVF/ET cycles were examined from patient data of two university hospital infertility clinics. All included patients were positive for β-human chorionic gonadotropin (hCG) at 2 weeks after oocyte retrieval via controlled ovarian stimulation. For each cycle, information on age, duration of infertility, basal follicle stimulating hormone (FSH), anti-Mullerian hormone (AMH), days of ovarian stimulation, numbers of retrieved oocytes and transferred embryos, and pregnancy outcomes was collected. Patients with AMH lower than 1.0 ng/dL or basal FSH higher than 10 mIU/mL were classified into the decreased ovarian reserve (DOR) group, and the remaining patients were classified into the normal ovarian reserve (NOR) group.
Results: In total, 355 cycles showed NOR, and 75 cycles DOR. There were no significant differences between the DOR and NOR groups regarding intrauterine (74.7% vs. 83.4%, respectively) or chemical (14.7% vs. 14.1%, respectively) pregnancies. The DOR group had a higher EP than that of NOR group [10.7% (8/75) vs. 2.5% (9/355), p=0.004]. In both univariate [odds ratio (OR) 5.6, 95% confidence interval (CI) 1.4?9.6, p=0.011] and multivariate (adjusted OR 5.1, 95 % CI 1.1?18.7, p=0.012) analysis, DOR was associated with a higher risk of EP.
Conclusion: DOR may be associated with a higher risk of EP in IVF/ET cycles with controlled ovarian stimulation. More careful monitoring may be necessary for pregnant women with DOR.
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KEYWORD
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Anti-Mullerian hormone, follicle stimulating hormone, ectopic pregnancy, in vitro fertilization, ovarian stimulation
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