Fertility outcomes subsequent to medical and surgical treatment for ectopic pregnancy: A retrospective cohort study in Iran

Abstract Background: Ectopic pregnancy (EP) and its treatment methods may affect subsequent fertility outcomes. Objective: To compare methotrexate (MTX), laparoscopic salpingostomy, and salpingectomy methods of EP treatment and their effects on fertility outcomes. Materials and Methods: This retrosp...

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Autores principales:	Zahra Asgari, Venus Chegini, Reihaneh Hosseini, Mina Mohajeri, Iman Ansari
Formato:	article
Lenguaje:	EN
Publicado:	Shahid Sadoughi University of Medical Sciences 2021
Materias:	ectopic pregnancy, fertility, methotrexate, salpingostomy, salpingectomy. Gynecology and obstetrics RG1-991 Reproduction QH471-489
Acceso en línea:	https://doaj.org/article/870594a661ff46afb5a522f8d911b2af
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spelling	oai:doaj.org-article:870594a661ff46afb5a522f8d911b2af2021-11-16T07:24:40ZFertility outcomes subsequent to medical and surgical treatment for ectopic pregnancy: A retrospective cohort study in Iran2476-41082476-377210.18502/ijrm.v19i10.9820https://doaj.org/article/870594a661ff46afb5a522f8d911b2af2021-10-01T00:00:00Zhttps://doi.org/10.18502/ijrm.v19i10.9820https://doaj.org/toc/2476-4108https://doaj.org/toc/2476-3772Abstract Background: Ectopic pregnancy (EP) and its treatment methods may affect subsequent fertility outcomes. Objective: To compare methotrexate (MTX), laparoscopic salpingostomy, and salpingectomy methods of EP treatment and their effects on fertility outcomes. Materials and Methods: This retrospective cohort study was performed on women receiving a definitive diagnosis of tubular EP from 2014 to 2017 at Arash Medical Center, Tehran, Iran. In total, 194 women were studied, of which 64 were treated with MTX, 52 underwent salpingostomy, and 78 underwent salpingectomy, depending on their clinical status. Basic information, obstetrics history, and major outcomes of the treatment after an 18-month follow-up, including recurrence of EP, miscarriage, and successful intrauterine pregnancy (IUP), were recorded and variables were compared among the three groups. Results: There was no significant difference in fertility outcomes among the three groups. Among the studied variables, predictors of successful IUP after EP treatment were multiparity (Hazard Ratio (HR): 1.37; 95%CI: 1.06-1.77), no history of miscarriage (HR: 2.37; 95%CI: 1.01-5.56), and a higher number of live births (HR: 1.54; 95%CI: 1.01-2.37). On the other hand, predictors of EP recurrence included nulliparity (HR: 1.61; 95%CI: 1.02-2.53) and a lower number of live births (HR: 3.84; 95%CI: 1.43-10.98). The effect of other factors, including the utilized therapeutic modalities, was not statistically significant. Conclusion: The current study results demonstrated that after an 18-month follow-up, fertility outcomes, including recurrence of EP and successful IUP, were not significantly different among the subjects with EP treated with MTX, salpingostomy, or salpingectomy. Further studies with long-term follow-ups are recommended.Zahra AsgariVenus CheginiReihaneh HosseiniMina MohajeriIman AnsariShahid Sadoughi University of Medical Sciencesarticleectopic pregnancy, fertility, methotrexate, salpingostomy, salpingectomy.Gynecology and obstetricsRG1-991ReproductionQH471-489ENInternational Journal of Reproductive BioMedicine, Vol 19, Iss 10, Pp 881-888 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	ectopic pregnancy, fertility, methotrexate, salpingostomy, salpingectomy. Gynecology and obstetrics RG1-991 Reproduction QH471-489
spellingShingle	ectopic pregnancy, fertility, methotrexate, salpingostomy, salpingectomy. Gynecology and obstetrics RG1-991 Reproduction QH471-489 Zahra Asgari Venus Chegini Reihaneh Hosseini Mina Mohajeri Iman Ansari Fertility outcomes subsequent to medical and surgical treatment for ectopic pregnancy: A retrospective cohort study in Iran
description	Abstract Background: Ectopic pregnancy (EP) and its treatment methods may affect subsequent fertility outcomes. Objective: To compare methotrexate (MTX), laparoscopic salpingostomy, and salpingectomy methods of EP treatment and their effects on fertility outcomes. Materials and Methods: This retrospective cohort study was performed on women receiving a definitive diagnosis of tubular EP from 2014 to 2017 at Arash Medical Center, Tehran, Iran. In total, 194 women were studied, of which 64 were treated with MTX, 52 underwent salpingostomy, and 78 underwent salpingectomy, depending on their clinical status. Basic information, obstetrics history, and major outcomes of the treatment after an 18-month follow-up, including recurrence of EP, miscarriage, and successful intrauterine pregnancy (IUP), were recorded and variables were compared among the three groups. Results: There was no significant difference in fertility outcomes among the three groups. Among the studied variables, predictors of successful IUP after EP treatment were multiparity (Hazard Ratio (HR): 1.37; 95%CI: 1.06-1.77), no history of miscarriage (HR: 2.37; 95%CI: 1.01-5.56), and a higher number of live births (HR: 1.54; 95%CI: 1.01-2.37). On the other hand, predictors of EP recurrence included nulliparity (HR: 1.61; 95%CI: 1.02-2.53) and a lower number of live births (HR: 3.84; 95%CI: 1.43-10.98). The effect of other factors, including the utilized therapeutic modalities, was not statistically significant. Conclusion: The current study results demonstrated that after an 18-month follow-up, fertility outcomes, including recurrence of EP and successful IUP, were not significantly different among the subjects with EP treated with MTX, salpingostomy, or salpingectomy. Further studies with long-term follow-ups are recommended.
format	article
author	Zahra Asgari Venus Chegini Reihaneh Hosseini Mina Mohajeri Iman Ansari
author_facet	Zahra Asgari Venus Chegini Reihaneh Hosseini Mina Mohajeri Iman Ansari
author_sort	Zahra Asgari
title	Fertility outcomes subsequent to medical and surgical treatment for ectopic pregnancy: A retrospective cohort study in Iran
title_short	Fertility outcomes subsequent to medical and surgical treatment for ectopic pregnancy: A retrospective cohort study in Iran
title_full	Fertility outcomes subsequent to medical and surgical treatment for ectopic pregnancy: A retrospective cohort study in Iran
title_fullStr	Fertility outcomes subsequent to medical and surgical treatment for ectopic pregnancy: A retrospective cohort study in Iran
title_full_unstemmed	Fertility outcomes subsequent to medical and surgical treatment for ectopic pregnancy: A retrospective cohort study in Iran
title_sort	fertility outcomes subsequent to medical and surgical treatment for ectopic pregnancy: a retrospective cohort study in iran
publisher	Shahid Sadoughi University of Medical Sciences
publishDate	2021
url	https://doaj.org/article/870594a661ff46afb5a522f8d911b2af
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_version_	1718426615299440640

Fertility outcomes subsequent to medical and surgical treatment for ectopic pregnancy: A retrospective cohort study in Iran

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