Iranian Society of Gynecology Oncology

Document Type : Original Research Article


1 Department of Radiology, Zahedan University of Medical Sciences, Zahedan, Iran

2 Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran

3 Department of Obstetrics and Gynecology, Zahedan University of Medical Sciences, Zahedan, Iran

4 Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran


Background: Ectopic pregnancy (EP) is one of the important issues in the field of obstetrics and gynecology. Proper assessment of fallopian tube patency following medical treatment of an EP in women who wish to have future children seems reasonable. Therefore, the purpose of this study was to investigate the patency of fallopian tubes after clinical and surgical treatment of EP.
Methods: In this quasi-experimental study, our research population was 270 people who were referred to Ali-Ibn-Abitaleb hospital in Zahedan with a definite diagnosis of EP in 2020. Patients were divided into three groups: drug treatment (90 people), surgical treatment (90 people) and expectant treatment (90 people). For each patient, the patency of the left and right fallopian tubes was investigated and the obtained data were statistically analyzed by t-test and chi-square test methods using SPSS software version 22 (IBM, USA).
Results: A total of 270 patients were examined. The mean age of the patients in the drug treatment, surgical therapy and expectant treatment groups were 32.34 ± 6.17, 32.02 ± 6.12 and 32.12 ± 6.40 years, (P=0.389). Moreover, there was no statistically significant difference between the right fallopian tubes (P=1.00), and the left fallopian tubes in the investigated groups (P=0.08).
Conclusion: Based on the results of this study, there was no statistically significant difference between the drug treatment and the surgery treatment groups. The findings of this study revealed that the uterine tube opening was similar on both sides after drug treatment, surgical treatment and expectant treatment.


Main Subjects

1. Yadav P, Singla A, Sidana A, Suneja A, Vaid NB. Evaluation of sonographic endometrial patterns and endometrial thickness as predictors of ectopic pregnancy. Int J Gynaecol Obstet. 2017;136(1):70-5. [DOI:10.1002/ijgo.12020] [PMID]
2. Guerriero S, Martins W, Alcazar J. Managing ultrasonography in human reproduction: a practical handbook: Switzerland: Springer; 2016. [DOI:10.1007/978-3-319-41037-1]
3. Taran FA, Kagan KO, Hübner M, Hoopmann M, Wallwiener D, Brucker S. The Diagnosis and Treatment of Ectopic Pregnancy. Dtsch Arztebl Int. 2015;112(41):693-703. [DOI:10.3238/arztebl.2015.0693] [PMID] [PMCID]
4. Nankali A, Shirzadi N, Rezaei M, Daeichin S. Trends in the Treatment and Clinical Presentations of Tubal Ectopic Pregnancy in Imam Reza Hospital of Kermanshah, Iran (2007-2011). Iran J Obstet Gynecol Infertil. 2014;17(95):1-7.
5. Rana P, Kazmi I, Singh R, Afzal M, Al-Abbasi FA, Aseeri A, et al. Ectopic pregnancy: a review. Arch Gynecol Obstet. 2013;288(4):747-57. [DOI:10.1007/s00404-013-2929-2] [PMID]
6. Khalid T, Elahi N. Clinical presentation of chronic ectopic pregnancy. J Coll Physicians Surg Pak. 2000;10:200-3.
7. Richardson A, Gallos I, Dobson S, Campbell BK, Coomarasamy A, Raine-Fenning N. Accuracy of first-trimester ultrasound in diagnosis of tubal ectopic pregnancy in the absence of an obvious extrauterine embryo: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2016;47(1):28-37. [DOI:10.1002/uog.14844] [PMID]
8. Sakhavar N, Mirteimoori M. A case report: Intestinal Obstruction in laparatomy with diagnosis of ectopic pregnancy. Zahedan J Res Med Sci. 2006;8(1):e94911.
9. Alkatout I, Honemeyer U, Strauss A, Tinelli A, Malvasi A, Jonat W, et al. Clinical Diagnosis and Treatment of Ectopic Pregnancy. Obstet Gynecol Surv. 2013;68(8):571-81. [DOI:10.1097/OGX.0b013e31829cdbeb] [PMID]
10. Santos-Ribeiro S, Tournaye H, Polyzos NP. Trends in ectopic pregnancy rates following assisted reproductive technologies in the UK: a 12-year nationwide analysis including 160 000 pregnancies. Hum Reprod. 2016;31(2):393-402. [DOI:10.1093/humrep/dev315] [PMID]
11. Gurel S, Sarikaya B, Gurel K, Akata D. Role of sonography in the diagnosis of ectopic pregnancy. Clin Ultrasound. 2007;35(9):509-17. [DOI:10.1002/jcu.20402] [PMID]
12. Chohan A. Ectopic pregnancy. Fundamentals of gynecology Lahore: MAR Publisher; 2000. p. 3-95.
13. Bangsgaard N, Lund CO, Ottesen B, Nilas L. Improved fertility following conservative surgical treatment of ectopic pregnancy. BJOG. 2003;110(8):765-70. [DOI:10.1111/j.1471-0528.2003.02253.x] [PMID]
14. Agdi M, Tulandi T. Surgical treatment of ectopic pregnancy. Best Pract Res Clin Obstet Gynaecol. 2009;23(4):519-27. [DOI:10.1016/j.bpobgyn.2008.12.009] [PMID]
15. Speroff L, Fritz MA. Clinical gynecologic endocrinology and infertility: lippincott Williams & wilkins; 2005.
16. Barnhart K, Coutifaris C, Esposito M. The pharmacology of methotrexate. Expert Opin Pharmacother. 2001;2(3):409-17. [DOI:10.1517/14656566.2.3.409] [PMID]
17. Elito J, Han KK, Camano L. Tubal patency after clinical treatment of unruptured ectopic pregnancy. Int J Gynaecol Obstet. 2005;88(3):309-13. [DOI:10.1016/j.ijgo.2004.12.018] [PMID]
18. Debby A, Golan A, Sadan O, Zakut H, Glezerman M. Fertility outcome following combined methotrexate treatment of unruptured extrauterine pregnancy. BJOG. 2000;107(5):626-30. [DOI:10.1111/j.1471-0528.2000.tb13304.x] [PMID]
19. Rantala M, Mäkinen J. Tubal patency and fertility outcome after expectant management of ectopic pregnancy. Fertil Steril. 1997;68(6):1043-6. [DOI:10.1016/S0015-0282(97)00414-7] [PMID]
20. Garcia Grau E, Checa Vizcaíno MÁ, Oliveira M, Lleberia Juanós J, Carreras Collado R, Canet Estevez Y. The Value of Hysterosalpingography following Medical Treatment with Methotrexate for Ectopic Pregnancy. Obstet Gynecol Int. 2011;2011:547946. [DOI:10.1155/2011/547946] [PMID] [PMCID]
21. Mol BWJ, Swart P, Bossuyt PMM, van Beurden M, van der Veen F. Reproducibility of the interpretation of hysterosalpingography in the diagnosis of tubal pathology. Hum Reprod. 1996;11(6):1204-8. [DOI:10.1093/oxfordjournals.humrep.a019356] [PMID]
22. National Collaborating Centre for Ws, Children's H. National Institute for Health and Clinical Excellence: Guidance. Fertility: Assessment and Treatment for People with Fertility Problems. London (UK)2004.
23. Spalding H, Tekay A, Martikainen H, Jouppila P. Assessment of tubal patency with transvaginal salpingosonography after treatment for tubal pregnancy. Hum Reprod. 1997;12(2):306-9. [DOI:10.1093/humrep/12.2.306] [PMID]
24. Elito Junior J, Han KK, Camano L. Tubal patency following surgical and clinical treatment of ectopic pregnancy. Sao Paulo Med J. 2006;124:264-6. [DOI:10.1590/S1516-31802006000500005] [PMID]
25. Chiu NC, Ho CH, Shen SH, Tsuei YC, Lee KL, Huang CY, et al. Impact of hysterosalpingography after operative treatment for ectopic pregnancy in Taiwan: A 16-year Nationwide Population-Based Analysis. Medicine. 2017;96(25):e7263. [DOI:10.1097/MD.0000000000007263] [PMID] [PMCID]
26. Fakheri T, Farshchian N, Rezaie M, Seyedzadeh SM. Comparison of the effect of single and multiple-dose methotrexate therapy on tubal patency in women with ectopic pregnancy. J Kurdistan Univ Medical Sci. 2016;20(6):26-33.