Survival analysis of fertility after ectopic pregnancy

Fertil Steril. 2001 Mar;75(3):560-6. doi: 10.1016/s0015-0282(00)01761-1.

Abstract

Objective: To evaluate the reproductive outcome after ectopic pregnancy and to assess the contribution of risk factors to future fertility.

Design: Prospective follow-up in a population-based sample.

Setting: Register of ectopic pregnancies established in an urban area around Lille, France.

Patient(s): Three hundred and twenty-eight women treated between April 1994 and March 1997 who had not been using an IUCD at the time of the ectopic pregnancy and were trying to become pregnant.

Intervention(s): Interviews by telephone every 6 months for 2 years and once yearly thereafter.

Main outcome measure(s): Cumulative pregnancy rate.

Result(s): Two hundred fifteen (65.5%) women became pregnant after a mean of 5 months. One hundred eighty-two (84.7%) pregnancies were intrauterine; 22 (10.2%) were recurrent ectopic pregnancies; and in 11 women (5.1%), it was too early to define implantation. The cumulative intrauterine pregnancy rate was 56% at 1 year and 67% at 2 years. After applying Cox regression, three factors associated with fertility seemed to decrease reproductive performance: age > 35 years, history of infertility, and anterior tubal damage .

Conclusion(s): More than half of the women treated for ectopic pregnancy spontaneously conceived and had a normally progressive pregnancy at 1 year. Fertility depends more on established patient characteristics than characteristics of ectopic pregnancy itself or treatment thereof.

MeSH terms

  • Adult
  • Ethnicity
  • Fallopian Tube Diseases / complications
  • Female
  • Follow-Up Studies
  • France / epidemiology
  • Humans
  • Infertility, Female / epidemiology
  • Infertility, Female / etiology*
  • Intrauterine Devices, Copper
  • Logistic Models
  • Methotrexate / therapeutic use
  • Odds Ratio
  • Pregnancy
  • Pregnancy Outcome
  • Pregnancy, Ectopic / complications*
  • Pregnancy, Ectopic / therapy
  • Prospective Studies
  • Risk Factors
  • Rupture, Spontaneous
  • Smoking / adverse effects

Substances

  • Methotrexate