Fertility after organ-preserving surgery of ectopic pregnancy: results of a multicenter study.
OBJECTIVE
To evaluate the postoperative fertility rate after ectopic pregnancy (EP) and to compare the impact of different surgical techniques.


METHODS
Prospective, multicenter trial.


METHODS
Twenty-five centers with microsurgical facilities.


METHODS
A total of 1,025 patients with EP were enrolled between 1984 and 1990.


METHODS
Organ-preserving operation and at least one patent remaining tube. Evaluation of postoperative outcome by standardized questionnaires.


METHODS
Postoperative fertility in terms of pregnancy rate (PR) and recurrent ectopic implantation.


RESULTS
The PR was similar after wedge resection (45.9%) and salpingotomy or milk out (42.0%). The recurrence rates did not differ between both groups (7.5% versus 8.2%). In patients with a blocked or absent contralateral tube, the PR was poor (31.2%), and the recurrence rate of EP was high (16.0%), indicating that most pregnancies are achieved through the contralateral tube.


CONCLUSIONS
The postoperative fertility rate after an EP is reduced. The type of surgery usually has no significant impact. In the case of a blocked or absent contralateral tube, the patient must be informed about the significantly reduced fertility rate and the elevated risk for EP recurrence.
Korell
M
M
Department of Obstetrics and Gynecology, Ludwig Maximilian University, Munich, Germany.
Albrich
W
W
Hepp
H
H
D000293:Adolescent; D000328:Adult; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D006801:Humans; D008866:Microsurgery; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000601:surgery*; D011446:Prospective Studies; D012008:Recurrence; D011795:Surveys and Questionnaires; D016896:Treatment Outcome