Abstract
To evaluate the fertility outcome after laparoscopic surgery for ectopic pregnancy. A randomized trial versus laparotomy was performed between May 1987 and June 1989. The study was conducted in a clinical university center, the Sahlgrens Hospital. A group of 105 patients with tubal pregnancy were stratified with regard to risk determinants and age and randomized to laparoscopy or laparotomy. Eighty-seven patients who desired pregnancy were evaluated for subsequent fertility outcome. Linear salpingotomy was performed in both surgical groups. We evaluated the fertility outcome after laparoscopic salpingotomy for comparison with the outcome after laparotomy. There was no difference between the groups in the overall fertility outcome. A substantially higher proportion of patients in the laparotomy group were subjected to adhesiolysis performed at a second-look laparoscopy. The fertility prospects are not impaired by laparoscopic surgery. Adhesiolysis at a second-look laparoscopy, especially after laparotomy, might be beneficial in selected cases and may serve to improve subsequent fertility.
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