title: Surgical treatment of ectopic pregnancy associated with predisposing factors of tuboperitoneal infertility.
abstract: OBJECTIVE
  We sought to study the advantages of laparoscopic conservative treatment and pelvic reproductive surgery in patients with ectopic pregnancy and predisposing factors of tuboperitoneal infertility.
  
  
  METHODS
  Patients who had undergone laparoscopic treatment for ectopic pregnancy were considered, with factors for tuboperitoneal infertility, while patients who underwent previous salpingectomy or assisted reproductive technology were excluded. The groups treated by salpingotomy (conservative) or salpingectomy (radical) were compared in terms of spontaneous intrauterine pregnancy rate, cumulative one-year pregnancy rate and recurrence of ectopic pregnancy. We considered patients treated with adhesiolysis, fimbrioplasty, and neosalpingostomy for tubal pathology as part of the fertility surgery group.
  
  
  RESULTS
  Among 41 considered patients, 21 (51%) underwent conservative laparoscopic management of ectopic pregnancy. Twenty patients (49%) had salpingectomy. Despite the treatment of tuboperitoneal infertility factors in both groups, the pregnancy rate was significantly higher in the conservative group than in the radical one (76% vs 25%, p < 0.05). The overall cumulative rate of ectopic pregnancy recurrence was 22% and no significant difference was found between conservative and radical treatment (p 0.645).
  
  
  CONCLUSIONS
  Salpingotomy should be preferred in all patients with ectopic pregnancy associated with factors of tuboperitoneal infertility. Infertility surgery clearly cannot help patients treated with salpingectomy, who obtain lower spontaneous pregnancy rates than those of the conservative group.
authors.affiliation: Clinic of Obstetrics and Gynecology, AOU SM della Misericordia, Udine, Italy. angelo_calcagno@hotmail.com
authors.forename: Angelo
authors.initials: A
authors.lastname: Calcagno
authors.forename: Ambrogio P
authors.initials: AP
authors.lastname: Londero
authors.forename: Thierry
authors.initials: T
authors.lastname: Haag
authors.forename: Lorenza
authors.initials: L
authors.lastname: Driul
authors.forename: Serena
authors.initials: S
authors.lastname: Bertozzi
authors.forename: Tiziana
authors.initials: T
authors.lastname: Grassi
authors.forename: Diego
authors.initials: D
authors.lastname: Marchesoni
authors.forename: Hubert
authors.initials: H
authors.lastname: Manhes
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate; D011271:Pregnancy, Ectopic / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D058994:Salpingectomy / Q000379:methods*; D012489:Salpingostomy / Q000379:methods*