From the Guidelines
There is no established direct link between BRCA1 gene mutations and increased risk of ectopic pregnancy. BRCA1 mutations are primarily associated with increased risks of breast and ovarian cancers, but current medical evidence, as seen in the 2020 study published in Annals of Oncology 1, does not support that they specifically increase the likelihood of ectopic pregnancies. Ectopic pregnancies are typically caused by factors such as:
- Previous pelvic inflammatory disease
- Prior tubal surgery
- Previous ectopic pregnancy
- Certain sexually transmitted infections
- Smoking
- Endometriosis
- Or fertility treatments
While BRCA1 carriers may undergo prophylactic surgeries like salpingo-oophorectomy (removal of fallopian tubes and ovaries) to reduce cancer risk, which would eliminate the possibility of tubal ectopic pregnancies, the gene mutation itself is not considered a risk factor for ectopic pregnancy. The study 1 focuses on fertility preservation and post-treatment pregnancies in post-pubertal cancer patients, highlighting the importance of oncofertility counselling and the use of preimplantation genetic diagnosis (PGD) for patients interested in this option. If you have BRCA1 mutations and are concerned about pregnancy risks, consulting with both a genetic counselor and an obstetrician-gynecologist would be advisable for personalized guidance.
From the Research
Ectopic Pregnancy and BRCA1 Gene
- There is no direct evidence to suggest that the BRCA1 gene increases the risk of ectopic pregnancy 2, 3, 4.
- Studies have investigated the relationship between BRCA1 and BRCA2 mutations and the risk of breast cancer, as well as the effects of pregnancy on this risk 2, 3.
- However, these studies do not provide information on the specific risk of ectopic pregnancy associated with the BRCA1 gene.
- Other studies have examined the treatment of ectopic pregnancy with methotrexate, but do not mention the BRCA1 gene as a risk factor 5, 6.
Risk Factors for Ectopic Pregnancy
- Higher levels of human chorionic gonadotropin (hCG) and progesterone have been associated with an increased risk of treatment failure for ectopic pregnancy 5, 6.
- The number of embryos transferred during in vitro fertilization (IVF) has also been linked to the risk of ectopic pregnancy 5.
- Adnexal masses detected by ultrasound have been correlated with an increased risk of requiring additional treatment for ectopic pregnancy 5.