Reproductive outcome following two ectopic pregnancies

Consideration of reproductive potential following multiple ectopic pregnancies is important in counseling patients and when choosing a conservative surgical approach (salpingotomy, salpingostomy), partial salpingectomy, or in vitro fertilization. The cases of 336 patients at Yale-New Haven Hospital who had ectopic pregnancies between 1976 and 1981 were evaluated. Thirty-two patients (9.5%) had two ectopic pregnancies. Twenty-three patients (71.8%) were followed. Six of these (26.1%) were not able to conceive because of surgical sterilization, and four (17.4%) were not trying to conceive. Of those 13 patients (56.5%) actively trying to conceive and having at least one tube remaining, 4 (30.8%) had term intrauterine gestations. One had a third ectopic gestation, which represented 20% of all conceptions, or 7.7% of those individuals trying to conceive. Our results indicate that although the reproductive potential after two ectopic pregnancies is poor, viable pregnancies do occur, and the repeat ectopic pregnancy rate is not high enough to preclude a repeat conservative surgical approach.