IVF And Ectopic Pregnancy
One of the potential risks of fertility treatments such as In-Vitro Fertilisation (IVF) and Intrauterine Insemination (IUI) is the increased chance of ectopic pregnancy. Ectopic pregnancy occurs when a woman’s egg is fertilised by her partner’s sperm and the resulting embryo implants somewhere outside the woman’s womb. When an embryo grows outside the womb, a potentially life-threatening situation is created for both mother and foetus. Health statistics show that approximately 1 % of all pregnancies are ectopic. Although ectopic pregnancies can occur also when a woman conceives naturally, fertility treatments such as IVF or IUI increase a fertility patient’s chances of her pregnancy being ectopic.
How Ectopic Pregnancy Begins
In a normal pregnancy, a woman’s ovary releases an egg which travels down her fallopian tube on the way to her womb. On its way, the egg is fertilised by a man’s sperm to create an embryo. The embryo then finishes its journey as described above and implants in the womb, where, hopefully, a healthy baby will grow over the course of the next nine months. According to NHS statistics, in 95 % of ectopic pregnancies, the embryo remains in the fallopian tube – although ectopic pregnancy can occur in the cervix (the neck of the womb), the ovary and the abdominal cavity. The danger is that the affected organ will rupture and cause severe bleeding. The vast majority of ectopic pregnancies in the United Kingdom are treated effectively. Very few ectopic pregnancies actually result in the death of the mother. Generally, an embryo cannot survive an ectopic pregnancy and therefore treatment nearly always requires the removal of the embryo. Even if the ectopic pregnancy is not treated the embryo will probably not survive, although the decision not to treat the ectopic pregnancy is a highly risky one for the mother.
During IVF treatment, a woman’s eggs are removed directly from her ovaries and are fertilised with her partner’s sperm outside her body (in a laboratory). The resulting embryos are then inserted directly into her womb. Given that most ectopic pregnancies occur when a fertilised egg gets stuck in the fallopian tube, you might ask how IVF could possibly increase the chances of ectopic pregnancy, since IVF “bypasses” the fallopian tubes altogether. Fertility specialists believe that ectopic pregnancy may occur if, when the embryos are transferred to the womb, they are placed too high in the womb cavity. The embryos then have a greater chance of “wandering” and implanting themselves in places where they are not supposed to be, such as the fallopian tubes. Embryos could also make their way into the fallopian tubes if they are injected into the womb with too much force. In the past, doctors would block the fallopian tubes during IVF treatment to try and prevent ectopic pregnancy from occurring. This method is no longer used.
IUI treatment involves inserting sperm directly into the womb cavity to help the sperm reach and fertilize a woman’s egg. This treatment may also increase the risk of a pregnancy developing in the fallopian tubes or elsewhere if the sperm is injected with too much force or is placed too high in the womb cavity.
What Are The Chances?
Between 2 and 5 % of IVF treatments result in ectopic pregnancy. If you are undergoing either IVF or IUI treatment and you do get pregnant, keep an eye out for symptoms of ectopic pregnancy. If you believe you are experiencing any of these symptoms, get medical help immediately.