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Fertility outcomes subsequent to medical and surgical treatment for ectopic pregnancy: A retrospective cohort study in Iran
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 co...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Knowledge E
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8595907/ https://www.ncbi.nlm.nih.gov/pubmed/34805728 http://dx.doi.org/10.18502/ijrm.v19i10.9820 |
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author | Asgari, Zahra Chegini, Venus Hosseini, Reihaneh Mohajeri, Mina Ansari, Iman |
author_facet | Asgari, Zahra Chegini, Venus Hosseini, Reihaneh Mohajeri, Mina Ansari, Iman |
author_sort | Asgari, Zahra |
collection | PubMed |
description | 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 | Online Article Text |
id | pubmed-8595907 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Knowledge E |
record_format | MEDLINE/PubMed |
spelling | pubmed-85959072021-11-19 Fertility outcomes subsequent to medical and surgical treatment for ectopic pregnancy: A retrospective cohort study in Iran Asgari, Zahra Chegini, Venus Hosseini, Reihaneh Mohajeri, Mina Ansari, Iman Int J Reprod Biomed Original Article 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. Knowledge E 2021-11-04 /pmc/articles/PMC8595907/ /pubmed/34805728 http://dx.doi.org/10.18502/ijrm.v19i10.9820 Text en Copyright © 2021 Asgari et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Asgari, Zahra Chegini, Venus Hosseini, Reihaneh Mohajeri, Mina Ansari, Iman Fertility outcomes subsequent to medical and surgical treatment for ectopic pregnancy: A retrospective cohort study in Iran |
title | 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_short | 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 |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8595907/ https://www.ncbi.nlm.nih.gov/pubmed/34805728 http://dx.doi.org/10.18502/ijrm.v19i10.9820 |
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