[Fertility after conservative surgical treatment of ectopic pregnancy, evaluated by a randomized trial]

In order to evaluate the fertility outcome after laparoscopic surgery for ectopic pregnancy, randomised trial of laparoscopy versus laparotomy was performed between May 1987 and June 1989. The study was conducted in a clinical university centre, Sahlgrens Hospital. A group a 105 patients with tubal pregnancy were stratified with regard to risk determinants and age randomized to laparoscopy or laparotomy. Eighty-seven patients who desired pregnancy were evaluated for subsequent fertility outcome. Linear salpingotomy was performed in both groups. The fertility outcome after laparoscopic salpingotomy was compared with that following laparotomy. There was no difference between the groups in the overall fertility outcome. A substantially higher proportion of patients in the laparotomy group were subjected to adhesiolysis performed at a second-look laparoscopic surgery. Adhesiolysis at a second-look laparoscopy, especially after laparotomy, might be beneficial in selected cases and may serve to improve subsequent fertility.