[Ectopic pregnancies with intrauterine devices. Characteristics and subsequent fertility]

Out of the 503 ectopic pregnancies (EP) dealt with surgically using conservative laparoscopic techniques, 153 (30.42%) occurred in patients with an intrauterine device (IUD) in situ. Examination of the characteristics of the EP reveals that there is a significantly higher proportion located in the isthmus in the group of patients without an IUD, whereas the fimbrial location is more frequent among patients with an IUD. Whereas tube wall condition does not differ according to the presence or absence of an IUD, adhesions and obstructed or not existent contralateral tubes are significantly less frequent among patients with an IUD in situ. 223 patients desired pregnancy, 30 of which had an IUD in situ when the EP was diagnosed. The subsequent fertility for these 30 patients with an IUD resulted in rates for intrauterine pregnancy (IUP), recurrent EP an infertility of 96.7%, 3.3%, and 0% respectively. These results are significantly better than those for women who had no IUD, the figures for their group being 59%, 13.4%, and 27.4% respectively. The favorable prognosis is due solely to the fact that women with an IUD have far less negative antecedents and that the EP probably occurred due to impaired ciliary action, reversible when the IUD is removed.