DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20150099

Factors influencing fertility outcome after ectopic pregnancy: a descriptive observational study

Veena KS, Vidyameena R, Rupavani Kollipaka

Abstract


Background: Ectopic pregnancy is the commonest gynecological emergencies. If not treated timely, threatens the life but also places major morbidity on future fertility. This study performed to determine the future pregnancy outcomes following surgical management of ectopic pregnancy and factors influencing the outcome.

Methods: Prospective observational study conducted at Tertiary Hospital. Records of patients with ectopic pregnancy between 2005 to 2010 traced, interviewed about fertility outcomes and the risk factors using a structured questionnaire. Patients followed for 3 years from index ectopic pregnancy. The main outcome measure was the occurrence of intrauterine   pregnancy or ectopic pregnancy at 3 years of follow-up after the index ectopic pregnancy.

Results: 64 patients with primary ectopic formed the basis of the study. 84.37% of patients undergone radical surgery (salpingectomy) and 15.62% forming the conservative group (Salpingotomy/milking) were included. In 3 years follow up, 40% of conservative group and 59% of radical group had intrauterine pregnancy. 30% in conservative group and 46% of radical group had term delivery. 20% of conservative group and 18.51% in radical group had repeated ectopic. Incidence of term delivery in patients with the past history of sub fertility was 25% and without subfertility 46%. 17% with tubal pathology and 63% with normal tube had term pregnancy. 37% aged more than 30 years and 44.64% aged less than 30 years had term pregnancy.

Conclusions: Subfertility, tubal pathology and age will influence on future fertility outcome following ectopic pregnancy. Radical or conservative surgery does not have influence on future pregnancy outcome. 


Keywords


Ectopic pregnancy, Subfertility

Full Text:

PDF

References


Job-Spira N, Bouyer J, Pouly JL, Germain E, Coste J., Aublet-Cuvelier B, et al. Fertility after ectopic pregnancy: first results of a population-based cohort study in France. Hum Reprod. 1996;11(l):99-104.

Bouyer J, Coste J, Shojaei T, Pouly JL, Fernandez H, Gerbaud L, et al. Risk factors for ectopic pregnancy: a comprehensive analysis based on a large case-control, population-based study in France. Am J Epidemiol. 2003;157:185-94.

Bangsgaard N, Lund CO, Ottesen B, Nilas L. Improved fertility following conservative surgical treatment of ectopic pregnancy. BJOG. 2003;110:765-70.

Battacharyas, McLernon DJ, Lee AJ, Battacharya S. Reproductive outcome following ectopic pregnancy register based study. PLoS Med. 2012;9(6):e1001243.

Decherney A, Kase N. The conservative surgical management of unruptured ectopic pregnancy clinical prospective. Obstet Gynacol. 1979;54:451-5.

Leach Re. Ory SJ. Modern management of ectopic pregnancy clinical prospective. J Reprod Med. 1989;34:324-38.

Oelsner G, Morad J, Carp H, Marshiach S, Serr DM. Reproductive performance following conservative microsurgical management of tubal pregnancy. Br J Obstet Gynaecol. 1987;94:1078-88.

Sherman D, Langer R, Sadovsky G, Bukovsky I, Caspi E. Improved fertility following ectopic pregnancy. Fertil Steril. 1982;37:497-502.

Lindblom B, Hahlin M, Lundorff P, Thornburn J. Treatment of tubal pregnancy by laparoscope guided injection of prostaglandin f2 alpha. Fertil Steril. 1990;54:404-8.

Clausen I. Conservative versus radical surgery for tubal pregnancy - a review. Acta Obstet Gynecol Scand. 1996;75:8-12.

Collins JA, Grosirguani PG. Unexplained infertility: a review of diagnosis, prognosis, treatment efficacy and management. Int J Gynaecol Obstet. 1992;39:267-75.

Herve Fernandez, Perrine Capmas, Jean Philippe Lucot, Benoit Resch, Pierre Panel, Jeanbouyer for the GROG. Fertility after ectopic pregnancy. The DEMETER randomized trial. Hum Reprod. 2013;28(5):1247-53.

Hajenius PJ, Mol BW, Ankun WM, van der Veen F, Bossuyt PM. Intervention for tubal ectopic pregnancy. Cochrane Database Syst Rev. 2000;(1):CD000324.

Fernandez H, Marchal L, Vincent Y. Fertility after radical surgery for tubal pregnancy. Fertil Steril. 1998 Oct;70(4):680-6.

Herve Fernandez, Amelie. Ectopic pregnancy after infertility treatment. Modern diagnosis and therapeutic strategy. Hum Reprod Update. 2004;10(6):503-13.

Ali Abdelhamed M. Mostfa, Hossam M. Abdel-Rahman. The Prognostic value of tubal patency test after medical treatment of an ectopic pregnancy. J Clin Gynecol Obstet. 2012 Oct;1(4-5):67-70.

Mukul LV, Teal SB. Current management of ectopic pregnancy. Obstet Gynecol Clin North Am. 2007;34(3):403-19.