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May 25, 1984

Embryo Transfer and Ectopic Pregnancy-Reply

Author Affiliations

National Institutes of Health Bethesda, Md

JAMA. 1984;251(20):2660. doi:10.1001/jama.1984.03340440020016

In Reply.—  Iffy's letter links time in the menstrual cycle and location of the embryo as principle factors in the occurrence of ectopic pregnancy. His remarks on mechanisms—"reflux" and "flux"—follow more than 20 years of attention to understanding the origins of tubal and abdominal pregnancy.Indeed, our manipulations of primate embryos during a variety of laboratory studies have been associated with five ectopic (two tubal and three abdominal) pregnancies during the past 15 years at the National Institutes of Health.1,2 During that same interval, I observed only one spontaneous ectopic (tubal) pregnancy in a rhesus monkey, unassociated with experimental activities; the total number of pregnancies in those years would exceed 3,000. The "induced" cases probably resulted from retrograde lavage being used to collect eggs and embryos, either because we "missed" them or because normal gamete/embryo transport was disrupted by surgical trauma to the reproductive tract. My anecdotal observations fit