Improved fertility following ectopic pregnancy.

The reproductive performance subsequent to operative removal of ectopic pregnancy was examined in 154 women. They represent 64% of 242 women admitted for ectopic pregnancy between 1969 and 1979. The follow-up period averaged 4.2 years. The patients at risk had a conception rate of 81%, with a repeat ectopic pregnancy incidence of 7.8%, and 65% had at least one live birth. Postoperative infertility was significantly associated with (1) previous sterility, (2) coexistent periadnexal adhesions and/or tubual disease, (3) rupture of the ectopic pregnancy, and (4) older age. A statistically significant advantage of conservative over radical treatment, as regards future fertility, was demonstrated only in 53 patients with either history or findings suggestive of previously impaired fertility. Early, prerupture diagnosis and treatment, coupled with conservative and restorative measures, might account for the improved reproductive performance.