Fertility OK after tubal pregnancy treatment

Treatment with the drug methotrexate to end a tubal pregnancy does not appear to have any significant impact on future fertility, French researchers report.

A fertilized egg that implants in the fallopian tubes instead of the womb is a medical emergency. Ectopic pregnancy, as the condition is called, can be dealt with surgically or by medical drug treatment.

"Medical treatment of ectopic pregnancy appears an alternative to surgical strategy with a good fertility rate," Dr. Herve Fernandez told AMN Health.

Fernandez and colleagues at Antoine Beclere Hospital in Clamart note in the medical journal Fertility and Sterility that early detection of tubal pregnancy has led to less invasive and non-surgical methods of treatment.

To look at the effect a methotrexate-based approach might have on the subsequent chances of pregnancy, the researchers conducted a follow-up telephone survey of 126 patients who were given methotrexate to treat an ectopic pregnancy.

Of the 93 women who attempted to conceive, 76 (82 percent) became pregnant. A total of 64 pregnancies were spontaneous and 12 were the result of in vitro fertilization.

Fifty-two of the unassisted pregnancies occurred within the uterus, but 12 of these resulted in miscarriages. The other 12 women had another ectopic pregnancy.

After taking into account various factors, the researchers found that failure to become pregnant was only linked to a history of infertility. Thus, the team concludes that fertility depends more on the patient's "previous medical history than on her treatment for ectopic pregnancy."

SOURCE: Fertility and Sterility, August 2004.