Ivf and Ectopic Pregnancy – Decoding the Correlation!

If you are undergoing an IVF treatment, you might be clouded with numerous concerns. Conceiving with IVF does have an increased risk of complications. However, a knowledge of those complications will aid you in your journey and help you become adept at handling them if the need arises.

If you are looking to equip yourself with an awareness of IVF and ectopic pregnancies, read on to find out about ectopic pregnancy, its correlation with IVF and the signs of ectopic pregnancy after IVF.

An ectopic pregnancy occurs when a fertilised egg grows outside of the uterus.

An ectopic pregnancy occurs when a fertilised egg grows outside of the uterus. Almost all ectopic pregnancies, more than 90%, occur in a fallopian tube. As the pregnancy grows, it can cause the tube to burst (rupture). A rupture can cause major internal bleeding with severe abdominal pain. This can be a life-threatening emergency that needs immediate surgery.

Ivf and Ectopic Pregnancy

Ectopic pregnancies are considered a “black box” in the field of gynaecology because the causes of one are yet unknown. However, there are various risk factors for ectopic pregnancy and assisted reproductive technology, including IVF, is one of them.

According to studies, the incidence of ectopic pregnancies is estimated to be 1-2% in normal pregnancies. Whereas, in IVF, it is found to be 2-8% higher than that.

According to research, other risk factors of ectopic pregnancy during IVF include,

  • Tubal infertility
  • Pelvic inflammatory diseases
  • History of tubal surgery
  • History of ectopic pregnancy
  • Cigarette smoking
  • Endometriosis
  • A high volume of transfer media
  • Multiple embryo transfer
  • The embryonic stage of transfer (Embryo transfer at the blastocyst stage appears to be the most biologically appropriate stage for intrauterine implantation as earlier stages of embryo development occur normally within the Fallopian tube)
  • Controlled ovarian hyperstimulation
  • Faulty transfer technique

But, as the foetus grows, the following signs of ectopic pregnancy after IVF presents themselves:

  • Abnormal vaginal bleeding
  • Mild cramps/ discomfort in the abdomen
  • Mild pain on one side of the abdomen
  • Lower back pain

These signs are your cue to visit your gynaecologist asap. It is highly recommended to do an early scan, irrespective of the type of pregnancy. Because it is important to know that not all of you will experience these symptoms. 

At this point, ectopic pregnancy is treatable medically with methotrexate injection. The growth is observed over 24-48 hours and HCG levels are monitored. If the foetus continues to grow, another dose is administered or a less invasive laparoscopic surgery is performed.

If the pregnancy progresses unattended, it causes the rupture of the fallopian tube causing the following signs:

These signs of ectopic pregnancy mean a precarious situation and call for surgical intervention.

How Does Ivf Cause Ectopic Pregnancy?

IVF involves fertilising an egg in a laboratory (‘in-vitro’), before directly injecting it into the womb or uterus. So you might be wondering how the pregnancy can be ectopic, particularly as the fallopian tubes, the site of most ectopic pregnancies, aren’t involved.

Let us go through some theories,

  • In IVF an embryo is placed 1.8 cm from the top of the uterus. However, there are still 12-24 hours for implantation to occur giving the probability of uterine contractions to propel the embryo into the fallopian tube.
  • While injecting a fertilised egg, if done too forcefully can drive the embryo into the fallopian tube where it could implant.
  • Different hormonal milieus in IVF cycles like higher circulating concentrations of oestradiol leads to a reverse migratory process of the transferred embryos.
  • The hydrostatic force generated by the transfer medium can pull the embryo in the fallopian tube.
  • It has also been theorised that damaged tubes can suck the embryos back into them due to pressure differentials between the uterus and the tube.


It is evident that the incidence of ectopic pregnancies is more in IVF. But, it is reassuring to note that recent statistics say there is a decline in this rate and an even convincing rate for those without other risk factors. 

So have faith while you embark on your IVF journey. You do not have to worry when you are in the care of skilful professionals, who will make sure you are out of risk, be thorough with their assessment, and be extremely cautious if you are at risk. Their expertise in conjugation with state-of-art technology is sure to ensure the best outcome. 

So all you have to do is have faith and keep your eyes open for the signs of ectopic pregnancy after IVF.

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