Tubal patency after Laparoscopic salpingostomy versus Methotrexate therapy in undisturbed tubal pregnancy

Abstract

Future fertility after ectopic pregnancy is dependent on several factors, including age, history of infertility, history of previous EP, tubal rupture, and contralateral tubal lesion. Thus, it seems reasonable to assess tubal patency following a treatment of an ectopic pregnancy in those women who are willing to have future pregnancy. Aimed to: Compare between tubal patency after methotrexate & laparoscopic salpingostomy. The study included 72 patients equally divided in number into 2 main groups. First group: (36cases) Tubal ectopic pregnancy treated by MXT therapy single or multiple doses. Single dose regimen (MTX 1.0 mg/kg or 50 mg/m2 i.m or multiple dose regimen (MTX 1.0 mg/kg i.m days (0,2,4,6). Second group: - (36 cases) Tubal ectopic pregnancy treated by laparoscopic salpingostomy. After 3 months, we used laparoscopy with administration of methylene blue (MB) as a marker to detect the tubal patency. As regard to tubal patency, of 31 cases (86.1%) from 36 cases that treated by MTX were patent and 5 cases (13.9 %) were blocked. On the other side 21 cases (58.3 %) from 36 cases that treated by laparoscopic salpingostomy were patent and 15 cases (41.7 %) were blocked). Conclusions:Methotrexate is better than laparoscopic salpingostomy in treating undisturbed tubal pregnancy.