The effect of therapy for tubal ectopic pregnancy on subsequent reproductive capacity and the frequency of recurrence

Abstract

Objectives: Ectopic pregnancy (EP), which is defined as the implantation of an embryo outside the uterine cavity, occurs with notable frequency in the first trimester (especially between the sixth and ninth weeks of gestation) and can cause severe intra-abdominal bleeding and death. Treatment options include salpingotomy with tubal preservation, transampullar expression of the EP (“milking” of the tube), wedge excision with the chance for tubal reconstruction in a subsequent surgery and partial or complete salpingectomy. Drug treatment with Methotrexate (MTX) is also an option. Materials and Methods: In this retrospective study, we analysed the data of patients who had been treated for an EP in the gynaecological department of Hanover Medical School, Germany, between 2006 and 2013. Results: We observed a pregnancy rate of 73.1% in those who wanted to have children following EP treatment, and 33 women (28.2%) became pregnant a second time. The birth rate after EP increased from 67.1% in the first subsequent pregnancy to more than 80% in the second. The frequency of recurrent EP was 6.6% in the first pregnancy after surgery and 3% in the second. Conclusions: These data are encouraging for EP patients, who have a good chance to conceive, whether spontaneously, after tubal reconstructive surgery or using in vitro fertilisation (IVF).