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[Fertility after ectopic pregnancy: 10-year results in the Auvergne Registry]
J Bouyer1, H Fernandez, J Coste
1Hôpital de Bicêtre, INSERM U569, IFR69, 82, rue du Général-Leclerc, 94276 Le Kremlin-Bicêtre. bouyer@vjf.inserm.fr
Objectives:
The purpose of this work was to study the fertility after ectopic pregnancy (EP) according to the type of contraception at the time of EP (none, IUD, other) and treatment (medical, conservative surgical, radical).
Material And Methods:
Ten-year Auvergne EP registry data were analyzed (1626 women, among whom 741 tried to become pregnant again). Fertility was characterized by the time to a new pregnancy and its outcome (EP recurrence, intrauterine pregnancy (IUP)). The censored data methodology was used.
Results:
The rate of recurrence was much higher in women who had a IUD at the time of EP than in women without contraception. The opposite trend was observed for IUP (the rate of IUP was 1.7-fold higher in women who had a IUD at the time of EP). The rate of recurrence doubled in women treated medically. The rate of IUP was significantly lower in women given conservative treatment than in women given radical treatment.
Conclusion:
Contraception at the time of EP must be considered when studying subsequent fertility. The increase in rate of recurrence following medical treatment observed in the present study should be confirmed by others in search for an explanation. Our results point out the need for control trials on EP treatment, and provide data for planning such trials.