TY - JOUR
T1 - Optimal treatment for patients with ectopic pregnancies and a history of fertility-reducing factors
AU - Becker, Sven
AU - Solomayer, Erich
AU - Hornung, René
AU - Kurek, Raffael
AU - Banys, Malgorzata
AU - Aydeniz, Babur
AU - Franz, Heiko
AU - Wallwiener, Diethelm
AU - Fehm, Tanja
PY - 2011/1
Y1 - 2011/1
N2 - Purpose: With most ectopic pregnancy (EP) cases now diagnosed and treated early, a major concern has become future reproductive outcome. The aim of this study was to evaluate long-term reproductive outcome after salpingotomy versus salpingectomy in patients with and without additional fertility-reducing factors. Methods: As part of a prospective follow-up study, 261 patients underwent laparoscopic management of EP at our institution. History was taken specifically looking at preexisting risk factors for reduced fertility. Patients were then followed with regard to future reproductive events. Results: Of 261 patients, 196 (75%) reported a subsequent desire for pregnancy. 145 patients had undergone salpingotomy and 51 salpingectomy. In patients without prior history of fertility-reducing factors, the subsequent intrauterine pregnancy rates were >90% for both salpingotomy and salpingectomy groups irrespective of the surgical approach. In patients with preexisting fertility-reducing factors, postoperative intrauterine pregnancy rates were 75% in the salpingotomy group, but only 40% in the salpingectomy group (p < 0.05), showing maximal effect for conservative surgery. Conclusion: Laparoscopic salpingotomy is of particular benefit for patients with additional fertility-reducing factors desirous of future pregnancy. Reproductive outcome is excellent in patients without such risk factor, irrespective of the surgical approach.
AB - Purpose: With most ectopic pregnancy (EP) cases now diagnosed and treated early, a major concern has become future reproductive outcome. The aim of this study was to evaluate long-term reproductive outcome after salpingotomy versus salpingectomy in patients with and without additional fertility-reducing factors. Methods: As part of a prospective follow-up study, 261 patients underwent laparoscopic management of EP at our institution. History was taken specifically looking at preexisting risk factors for reduced fertility. Patients were then followed with regard to future reproductive events. Results: Of 261 patients, 196 (75%) reported a subsequent desire for pregnancy. 145 patients had undergone salpingotomy and 51 salpingectomy. In patients without prior history of fertility-reducing factors, the subsequent intrauterine pregnancy rates were >90% for both salpingotomy and salpingectomy groups irrespective of the surgical approach. In patients with preexisting fertility-reducing factors, postoperative intrauterine pregnancy rates were 75% in the salpingotomy group, but only 40% in the salpingectomy group (p < 0.05), showing maximal effect for conservative surgery. Conclusion: Laparoscopic salpingotomy is of particular benefit for patients with additional fertility-reducing factors desirous of future pregnancy. Reproductive outcome is excellent in patients without such risk factor, irrespective of the surgical approach.
UR - http://www.scopus.com/inward/record.url?scp=78751583940&partnerID=8YFLogxK
U2 - 10.1007/s00404-009-1270-2
DO - 10.1007/s00404-009-1270-2
M3 - Journal articles
C2 - 19902231
AN - SCOPUS:78751583940
SN - 0932-0067
VL - 283
SP - 41
EP - 45
JO - Archives of Gynecology and Obstetrics
JF - Archives of Gynecology and Obstetrics
IS - 1
ER -