Ectopic pregnancy rates with day ۳ versus day ۲ embryo transfer: a retrospective analysis

Ectopic pregnancy rates increase in ART-treated patients due to uterine contractions, hormonal effects on the endometrium, uterine tube factors, and improper embryo transfer. Studies have shown that cleavage transfer is associated with high risk of ectopic pregnancy. During this study, ectopic pregnancy rates were compared among the transfer of embryos on day ۳ versus day ۲.Materials and methodsThis study examined women who underwent in vitro fertilization/intracytoplasmic sperm injection in Royan institute during the period October ۲۰۱۵ to March ۲۰۲۰. Cleavage transfer has been performed depending on the results of ovulation stimulation and oocyte puncture. In EP cases, patient background, such as causes of infertility, fibrosis, ovarian problems, abdominal or pelvic surgery, number of failures in IVF cycles, number of previous ectopic pregnancies etc., have been examined.ResultsThere were ۳۲۵۳ clinical pregnancies resulting from cleavage transfers of which ۹۶ were ectopic (۲.۹۵%). The mean age of women was ۳۴.۰۴±۵.۵۲ years and the mean BMI ofparticipants was ۲۴.۹۴± ۴.۱۹ kg/m۲. In day ۲ transfers, there were ۶۷ (۶۹.۸%) ectopic pregnancies and in day three, ۲۹ (۳۰.۲%) ectopic pregnancies(۳.۹%). The difference between ectopic pregnancies in days ۲ and ۳ was statistically significant (P = ۰.۰۰).ConclusionsBased on our study, day ۳ embryo transfer reduce the number of ectopic pregnancies compared to day ۲ transfer. Studies have shown decreased uterine contractility later in the luteal phase would suggest lower ectopic pregnancy rates. So, we assume that the decreased number of EP in day ۳ transfer is related to decreased uterine contraction after ovulation stimulation and oocyte puncture. Nevertheless, the results of this study indicate that ectopic pregnancy risk factors should not be considered when deciding whether to transfer on day ۳ or day ۲.

Keywords:

Ectopic pregnancy , Implantation , Embryo transfer , Cleavage embryo transfer