The iPLEDGE system is a rigorous program designed to reduce fetal exposure to isotretinoin, and a study recently published in JAMA dermatology has examined the frequency and rate of pregnancy and pregnancy-related adverse events among women taking isotretinoin reported to the US Food and Drug Administration (FDA). Despite the serious risks involved, there were 6740 pregnancies among women taking isotretinoin reported Although the number of reports of pregnancies, abortions, and fetal defects among women taking isotretinoin has decreased the peak observed in 2006, the issue persists and vigilance is clearly still required. See the original paper here