A great question!

I began to write my response to Jenn's question in the comments section, but realized others might also have the same question, so it gets its own post.  :)

Jenn asked:
Did your doctors mention whether or not they can aid in avoiding placenta previa? Are they able to "shoot" the egg up high in your uterus, hoping it will attach in a higher location? (I know "shooting" the egg is not proper medical terminology. lol.) 


That's a really good question Jenn!

On Thursday when I went in for the final blood work and ultrasound, they mapped my uterus very carefully. I watched as the ultrasound tech highlighted the curve and basic "geography," including markers for both the cervix opening (mine points toward my back as opposed to most that point downward) and also the opening of the fallopian tubes.

When the RE begins the transfer, they insert a catheter into the uterus, placing the open end of the tube very close to the place where the fallopian tubes meet the uterus. This simulates exactly where an embryo at that stage of development would naturally be after fertilizing and completing the trip out of the tubes. Generally speaking, because of the placement, actually the risk of an ectopic pregnancy is greater than the risk of placenta previa.

Placenta previa is more often associated with women who have some sort of uterine irregularity, whether that's an abnormal shape, fibroids, scarring from surgery/csection/abortion/infection/previous pregnancies (especially multiples), or advanced maternal age.

So you might ask how IVF results in an increased risk of an ectopic pregnancy if it bypasses the tubes all together. :) The answer is that sometimes the male  embryos forget to ask directions before leaving the petri dish and start wondering around after they're placed. If the RE placed the embryo too high in the uterine cavity, or if they are injected too forcefully it encourages that risk. That is why the uterine mapping was so specific and why some RE prefer to place the embryo with ultrasound guidance.

The risk is generally only about 2-5% though. Most RE's do enough IVF procedures that it's second nature to them.

So that's probably a longer answer than you might have expected, but it's kind of fascinating, don't you think?  :)