Fertility outcome after conservative surgical treatment of ectopic pregnancy evaluated in a randomized trial.

OBJECTIVE

To evaluate the fertility outcome after laparoscopic surgery for ectopic pregnancy.

DESIGN

A randomized trial versus laparotomy was performed between May 1987 and June 1989.

SETTING

The study was conducted in a clinical university center, the Sahlgrens Hospital.

PATIENTS: A group of 105 patients with tubal pregnancy were stratified with regard to risk determinants and age and randomized to laparoscopy or laparotomy. Eighty-seven patients who desired pregnancy were evaluated for subsequent fertility outcome.

INTERVENTIONS: Linear salpingotomy was performed in both surgical groups.

MAIN OUTCOME MEASURE: We evaluated the fertility outcome after laparoscopic salpingotomy for comparison with the outcome after laparotomy.

RESULTS

There was no difference between the groups in the overall fertility outcome. A substantially higher proportion of patients in the laparotomy group were subjected to adhesiolysis performed at a second-look laparoscopy.

CONCLUSIONS

The fertility prospects are not impaired by laparoscopic surgery. Adhesiolysis at a second-look laparoscopy, especially after laparotomy, might be beneficial in selected cases and may serve to improve subsequent fertility.