The occurrence of non-tubal ectopic pregnancies in women with an intrauterine device

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Abstract
Approximately 1 pregnancy in 8 of those occurring in women with an intrauterine contraceptive device (IUD) is ectopic. It seems possible that an IUD produces tubal dysfunction, resulting in faulty egg pick-up, altered tubal transport time, or both. More fertilizations per yr occur in women with IUD than in a control group of fertile women. There would therefore be relatively more tubal, ovarian and abdominal pregnancies in the women with IUD because persisting intrauterine pregnancies are discouraged. The incidence of abdominal pregnancies is reported as being between 1 in 1372 and 1 in 7931 deliveries, depending on the population surveyed, but these figures would encompass cases starting as ovarian or tubal implantation as well as those associated with ectopic endometrium. The incidence of ovarian pregnancy (in a population not using the IUD for contraception) is .apprx. 1 in 25,000 pregnancies, i.e., 0.7-1% of all ectopic gestations. The real incidence may be higher than this because ovarian pregnancies can be missed unless bleeding follicles are serially sectioned. During a special study of ectopic pregnancies in women, 3 unequivocal cases of non-tubal ectopic implantation were found. They are described in the present report.

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