Reproductive outcome after multiple ectopic pregnancies

Seventy-six patients with two or more ectopic pregnancies treated at the Department of Obstetrics and Gynecology, University Central Hospital, Tampere, Finland over a period of 14 years (1972-1985) were retrospectively analyzed. Conservative tubal surgery had originally been performed in 57% of patients with a repeat tubal pregnancy, and in 41% of control patients with a single tubal pregnancy. After two ectopic pregnancies, 53 patients were actively trying to conceive. Of these patients, 25% achieved delivery, 40% had a third ectopic pregnancy, and 35% did not conceive. Ipsilateral tubal pregnancy occurred in 83% after salpingotomy, in 88% after fimbrial evacuation, and in 47% after tubal resection. Conservative surgery was performed in 16 patients with only one tube where an ectopic pregnancy occurred; 25% had a term delivery, 25% had a repeat ectopic pregnancy, and 50% did not conceive. Follow-up of 19 patients after three tubal pregnancies showed that 16% delivered, 26% had a repeat tubal pregnancy, and 58% did not conceive. There was no significant difference between fertility results after salpingectomy and those after conservative surgery.