Improving fertility after ectopic pregnancy


A new study compares the increase in fertility that women experience resulting from two very different fallopian tube surgeries to treat ectopic pregnancy. Salpingectomy is a surgical treatment in which the affected fallopian tube is removed. Salpingotomy is a procedure where the tube is repaired and preserved. About 3% of all pregnancies are ectopic. This complication is one of the leading causes of maternal death.

Salpingectomy versus salpingotomy

The reproductive endocrinologist Tamer Yalcinkaya, MD, from Wake Forest Baptist aimed to assess whether salpingotomy improved rates of subsequent pregnancy through natural conception. He compared these findings to the pregnancy rate of salpingectomy. “In women with a tubal pregnancy and a healthy opposite tube, salpingotomy does not significantly improve fertility prospects compared with salpingectomy,” explained Yalcinkaya. “We have pondered what we should do, but it’s never been studied. This study provides an answer – saving the fallopian tube does not show any improved benefit.”

Removing the tube better in many ways

Ongoing pregnancy by natural conception was about 61% after salpingotomy and 56% after salpingectomy. Doctors now know if the opposite tube is normal, the affected tube can be removed. This is a quicker, less complex procedure, less invasive and better for reducing the chance of another ectopic pregnancy. They found that continued growth of tissue happened more frequently in the repaired tube although repeat ectopic pregnancy occurred significantly in both. Repeat ectopic pregnancy occurred in 8% of the study group with repaired tube and 5% of women with removed tube.

Source: The Lancet, MedicalNewsToday


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