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
Hodgen GD. Embryo Transfer and Ectopic Pregnancy-Reply. JAMA. 1984;251(20):2660. doi:10.1001/jama.1984.03340440020016
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