Con la selección apropiada del paciente, los tratamientos expectante, médico y quirúrgico tienen tasas de éxito de 82%, 90% y 92%, respectivamente.[83]Trio D, Strobelt N, Picciolo C, et al. Prognostic factors for successful expectant management of ectopic pregnancy. Fertil Steril. 1995 Mar;63(3):469-72.
http://www.ncbi.nlm.nih.gov/pubmed/7851572?tool=bestpractice.com
[84]Shalev E, Peleg D, Tsabari A, et al. Spontaneous resolution of ectopic tubal pregnancy: natural history. Fertil Steril. 1995 Jan;63(1):15-9.
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[85]Lipscomb GH, McCord ML, Stovall TG, et al. Predictors of success of methotrexate treatment in women with tubal ectopic pregnancies. N Engl J Med. 1999 Dec 23;341(26):1974-8.
http://www.nejm.org/doi/full/10.1056/NEJM199912233412604#t=article
http://www.ncbi.nlm.nih.gov/pubmed/10607814?tool=bestpractice.com
La tasa de recurrencia de embarazo ectópico es de entre el 5% y el 20%, pero aumenta a >30% en mujeres con dos embarazos ectópicos consecutivos.[86]Tenore JL. Ectopic pregnancy. Am Fam Physician. 2000 Feb 15;61(4):1080-8.
https://www.aafp.org/afp/2000/0215/p1080.html
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[87]Tay JI, Moore J, Walker JJ. Ectopic pregnancy. BMJ. 2000 Apr 1;320(7239):916-9.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1117838
http://www.ncbi.nlm.nih.gov/pubmed/10742003?tool=bestpractice.com
Las tasas de fertilidad futura y de permeabilidad tubárica en las mujeres tratadas por laparoscopia son similares a las del grupo tratado médicamente.[46]ACOG practice bulletin no. 193: tubal ectopic pregnancy. Obstet Gynecol. 2018 Mar;131(3):e91-103.
http://www.ncbi.nlm.nih.gov/pubmed/29470343?tool=bestpractice.com
[56]Hendriks E, Rosenberg R, Prine L. Ectopic pregnancy: diagnosis and management. Am Fam Physician. 2020 May 15;101(10):599-606.
https://www.aafp.org/afp/2020/0515/p599.html
http://www.ncbi.nlm.nih.gov/pubmed/32412215?tool=bestpractice.com
[88]Fernandez H, Capmas P, Lucot JP, et al. Fertility after ectopic pregnancy: the DEMETER randomized trial. Hum Reprod. 2013 May;28(5):1247-53.
http://humrep.oxfordjournals.org/content/28/5/1247.long
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[89]Desroque D, Capmas P, Legendre G, et al. Fertility after ectopic pregnancy [in French]. J Gynecol Obstet Biol Reprod (Paris). 2010 Sep;39(5):395-400.
http://www.ncbi.nlm.nih.gov/pubmed/20478667?tool=bestpractice.com
En mujeres con una trompa contralateral normal, la salpingostomía no parece mejorar la fertilidad futura en comparación con la salpingectomía.[69]Po L, Thomas J, Mills K, et al. Guideline no. 414: management of pregnancy of unknown location and tubal and nontubal ectopic pregnancies. J Obstet Gynaecol Can. 2021 May;43(5):614-30.e1.
https://www.doi.org/10.1016/j.jogc.2021.01.002
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[80]Mol F, van Mello NM, Strandell A, et al. Salpingotomy versus salpingectomy in women with tubal pregnancy (ESEP study): an open-label, multicentre, randomised controlled trial. Lancet. 2014 Apr 26;383(9927):1483-9.
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[90]Cheng X, Tian X, Yan Z, et al. Comparison of the fertility outcome of salpingotomy and salpingectomy in women with tubal pregnancy: a systematic review and meta-analysis. PLoS One. 2016 Mar 25;11(3):e0152343.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4807767
http://www.ncbi.nlm.nih.gov/pubmed/27015601?tool=bestpractice.com
Ni el metotrexato ni la salpingectomía afectan la respuesta ovárica subsecuente y el embarazo con fertilización in vitro en mujeres tratadas por embarazo ectópico resultante de la fertilización in vitro.[91]Wiser A, Gilbert A, Nahum R, et al. Effects of treatment of ectopic pregnancy with methotrexate or salpingectomy in the subsequent IVF cycle. Reprod Biomed Online. 2013 May;26(5):449-53.
http://www.rbmojournal.com/article/S1472-6483(13)00064-3/fulltext
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[92]Boots CE, Hill MJ, Feinberg EC, et al. Methotrexate does not affect ovarian reserve or subsequent assisted reproductive technology outcomes. J Assist Reprod Genet. 2016 May;33(5):647-56.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4870444
http://www.ncbi.nlm.nih.gov/pubmed/26943917?tool=bestpractice.com
[93]Yoon SH, Lee JY, Kim SN, et al. Does salpingectomy have a deleterious impact on ovarian response in in vitro fertilization cycles? Fertil Steril. 2016 Oct;106(5):1083-92.e5.
https://www.fertstert.org/article/S0015-0282(16)61300-6/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/27336211?tool=bestpractice.com