Early recognition of ectopic pregnancy in an infertility population

On an infertility service, 170 patients were evaluated for possible ectopic pregnancy using tests for beta-human chorionic gonadotropin levels, ultrasound, and clinical examination. Thirty-four (20%) of those evaluated underwent laparoscopy, of whom 31 (91%) were found to have ectopic pregnancies. Only three of the ectopic pregnancies were ruptured; only two women had significant hemoperitoneum and only two required transfusion. Subsequent intrauterine pregnancy occurred in 5 of 11 patients who underwent salpingectomy (45%) and in 1 of 15 patients who underwent salpingotomy (7%). There were no subsequent pregnancies in five patients after expression of the ectopic from the tube. Early intervention in an infertile population decreases morbidity and may favor conservative tubal surgery, although our series could not confirm the benefits of such surgery.