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Fertil Steril. 1998 Oct;70(4):680-6.

Fertility after radical surgery for tubal pregnancy.

Author information

1
Department of Obstetrics and Gynecology, Antoine Béclère Hospital, Clamart, France.

Abstract

OBJECTIVE:

To evaluate fertility after salpingectomy performed for ectopic pregnancies (EPs).

DESIGN:

Retrospective cohort study.

SETTING:

Tertiary care university hospital.

PATIENT(S):

Three hundred forty patients (213 with surgery by laparoscopy and 127 by laparotomy) between January 1985 and July 1994, with a mean follow-up period of 73 months (36-162 months).

INTERVENTION(S):

Salpingectomy performed either by laparotomy or by laparoscopy as indicated.

MAIN OUTCOME MEASURE(S):

Rate of intrauterine pregnancy (IUP), live births, and recurrent EP.

RESULT(S):

Forty-seven (13.8%) patients were lost to follow-up, and 68 (20%) did not want to become pregnant. The overall rate of spontaneous conception was 70.4% in the laparoscopy group and 53.2% in the laparotomy group. The rate of live births was 50% and 37%, respectively; the mean time until conception was 11 and 17.2 months; and the rate of recurrent EP, 10.6% and 9.6%. The multivariate analysis showed a rate of IUP of 82.1% among women younger than 30 years of age with a normal contralateral tube, laparoscopic surgery, and no history of infertility.

CONCLUSIONS:

In this study of fertility after salpingectomy for EP, laparoscopic treatment was superior to laparotomic treatment. Fertility was equivalent to that after conservative treatment in a subgroup of young patients treated with laparoscopy and with no history of tubal pathology.

PMID:
9797098
DOI:
10.1016/s0015-0282(98)00251-9
[Indexed for MEDLINE]

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