Tubal patency and fertility outcome after expectant management of ectopic pregnancy.
OBJECTIVE
To study tubal patency and fertility outcome of patients with expectantly managed ectopic pregnancy (EP).


METHODS
A prospective study.


METHODS
Department of Obstetrics and Gynecology, Turku University Central Hospital, Turku, Finland.


METHODS
Thirty patients who wanted to become pregnant again were treated successfully by expectant management of EP.


METHODS
Patients were examined with posttreatment hysterosalpingography, and they filled out a questionnaire about their subsequent pregnancies.


METHODS
Free passage through open lumen showing tubal patency; number of full-term pregnancies and EPs revealing relative rate of subsequent fertility.


RESULTS
A free passage through the diseased tube was seen in 93% of the cases (28 of 30). Two of the 24 patients (8.4%) who wanted to become pregnant had an obstruction in the diseased tube. One (4.2%) of them had a normal opposite tube and later had a normal pregnancy. The other (4.2%) had an obstruction in both tubes and subsequently had a repeat EP. One of the 6 patients had an EP (this patient did not want to become pregnant and did not use contraception). However, her posttreatment hysterosalpingography was normal. In total, the subsequent pregnancy rate was 88% (21 of 24), and the rate of repeat EP was 4.2% (1 of 24).


CONCLUSIONS
Patients who are treated with expectant management have a good long-term fertility outcome. Spontaneous regression of EP does not lead to increased harm or damage to the tube, i.e., the risk for repeat EP is low.
Rantala
M
M
Department of Obstetrics and Gynecology, Turku University Central Hospital, Finland.
Mäkinen
J
J
D000328:Adult; D005187:Fallopian Tubes / Q000503:physiopathology*; D005260:Female; D005298:Fertility; D005500:Follow-Up Studies; D006801:Humans; D007047:Hysterosalpingography; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000503:physiopathology* / Q000628:therapy*; D011446:Prospective Studies