Survival analysis of fertility after ectopic pregnancy

Objective: To evaluate the reproductive outcome after ectopic pregnancy and to assess the contribution of risk factors to future fertility. Design: Prospective follow-up in a population-based sample. Setting: Register of ectopic pregnancies established in an urban area around Lille, France. Patient(s): Three hundred and twenty-eight women treated between April 1994 and March 1997 who had not been using an IUCD at the time of the ectopic pregnancy and were trying to become pregnant. Intervention(s): Interviews by telephone every 6 months for 2 years and once yearly thereafter. Main Outcome Measure(s): Cumulative pregnancy rate. Result(s): Two hundred fifteen (65.5%) women became pregnant after a mean of 5 months. One hundred eighty-two (84.7%) pregnancies were intrauterine; 22 (10.2%) were recurrent ectopic pregnancies; and in 11 women (5.1%), it was too early to define implantation. The cumulative intrauterine pregnancy rate was 56% at 1 year and 67% at 2 years. After applying Cox regression, three factors associated with fertility seemed to decrease reproductive performance: age > 35 years, history of infertility, and anterior tubal damage. Conclusion(s): More than half of the women treated for ectopic pregnancy spontaneously conceived and had a normally progressive pregnancy at 1 year. Fertility depends more on established patient characteristics than characteristics of ectopic pregnancy itself or treatment thereof. (C) 2001 by American Society for Reproductive Medicine.