Unilateral Salpingectomy and Methotrexate Are Associated With a Similar Recurrence Rate of Ectopic Pregnancy in Patients Undergoing In Vitro Fertilization

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“…Previous studies examining patients with history of EP that conceived naturally show that the recurrence rate of EP is comparable between patients who received MTX and those who underwent salpingectomy 10,11 . Similar results were reported by Irani et al 6 examining the recurrence rate of EP in IVF patients with previous EP by comparing the different treatment approaches. However, others reported a higher recurrence rate of EP post-salpingostomy compared to post-salpingectomy 8 .…”

“…The most common location of an EP is the fallopian tube 6 . Several theories suggest that abnormal fallopian tube pathology interferes with embryo transport, such as ciliary dysfunction, myosalpinx spasm secondary to prostaglandin release or incomplete relaxation, leading to EP 5,6 . Another common explanation is the chronic inflammation or infection after pelvic inflammatory disease affecting tubal patency 5,12 .…”

“…There are two common ways an EP is treated, either medically with the use of methotrexate (MTX) or surgically with salpingectomy or salpingostomy 6 . Given that the new diagnostic methods such as transvaginal ultrasound scans provide an earlier diagnosis of EP, the need for surgery has decreased 7 .…”

“…Previous studies have shown a trend favoring salpingostomy over salpingectomy, as preservation of both tubes is assumed to favor fertility 8,9 . However, focusing on EPs occurring in patients who are undergoing IVF, the use of MTX or unilateral salpingectomy are most commonly used, while salpingostomy is thought to be less beneficial as another IVF cycle is often required to achieve pregnancy 6 .…”

Risk Factors of Recurrent Ectopic Pregnancy in Patients Treated With in vitro Fertilization Cycles: A Matched Case-Control Study

“…In addition, our data also showed that there was no correlation between REP and the number of previous EPs. In contrast, a previous study reported that the risk of REP was increased with a history of a higher number of previous EPs (23).…”