Treatment with the drug methotrexate to end a tubal pregnancy does not appear to have any significant impact on future fertility. A fertilised egg that implants in the fallopian tubes instead of the womb may present as an emergency. Ectopic pregnancy, as the condition is called, can be dealt with surgically or by medical drug treatment. Medical management of ectopic pregnancy is an alternative to surgical strategy, and has a good fertility rate. Researchers from the Antoine Beclere Hospital in Clamart, France, said that early detection of tubal pregnancy leads to less invasive and non-surgical methods of treatment. To look at the effect a methotrexate-based approach has on the subsequent chances of pregnancy, the researchers conducted a follow-up survey of 126 patients who were given methotrexate to treat an ectopic pregnancy. Of the 93 women who attempted to conceive, 76 (82 percent) became pregnant. A total of 64 pregnancies were spontaneous and 12 were the result of in vitro fertilization. Fifty-two of the unassisted pregnancies occurred within the uterus, but 12 of these resulted in miscarriages. The other 12 women had another ectopic pregnancy. After taking into account various factors, the researchers found that failure to become pregnant was only linked to a history of infertility. Thus, they concluded that fertility depends more on the patient's previous medical history than on her treatment for ectopic pregnancy.
Fertility and Sterility,
August 2004