如果患者选择适当,期待疗法、药物治疗和手术治疗的成功率分别是 82%、90% 和 92%。[73]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[74]Shalev E, Peleg D, Tsabari A, et al. Spontaneous resolution of ectopic tubal pregnancy: natural history. Fertil Steril. 1995 Jan;63(1):15-9.http://www.ncbi.nlm.nih.gov/pubmed/7805905?tool=bestpractice.com[75]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=articlehttp://www.ncbi.nlm.nih.gov/pubmed/10607814?tool=bestpractice.com
异位妊娠复发率为 5%-20%,但在连续两次异位妊娠的女性中发病率升至>30%。[76]Tenore JL. Ectopic pregnancy. Am Fam Physician. 2000 Feb 15;61(4):1080-8.http://www.aafp.org/afp/2000/0215/p1080.htmlhttp://www.ncbi.nlm.nih.gov/pubmed/10706160?tool=bestpractice.com[77]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
接受腹腔镜治疗的患者,其未来的生育能力和输卵管通畅率与接受药物治疗的患者类似。[40]ACOG practice bulletin no. 193: tubal ectopic pregnancy. Obstet Gynecol. 2018 Mar;131(3):e91-103.https://journals.lww.com/greenjournal/fulltext/2018/03000/ACOG_Practice_Bulletin_No__193___Tubal_Ectopic.46.aspxhttp://www.ncbi.nlm.nih.gov/pubmed/29470343?tool=bestpractice.com[63]Barash JH, Buchanan EM, Hillson C. Diagnosis and management of ectopic pregnancy. Am Fam Physician. 2014 Jul 1;90(1):34-40.http://www.aafp.org/afp/2014/0701/p34.htmlhttp://www.ncbi.nlm.nih.gov/pubmed/25077500?tool=bestpractice.com[78]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.longhttp://www.ncbi.nlm.nih.gov/pubmed/23482340?tool=bestpractice.com[79]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 在对侧输卵管正常的女性中,与输卵管切除术相比,输卵管造口术似乎未改善生育前景。[70]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.http://www.ncbi.nlm.nih.gov/pubmed/24499812?tool=bestpractice.com[80]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
治疗因 IVF 所致的异位妊娠时,无论甲氨蝶呤还是输卵管切除术都不会影响患者日后的卵巢反应和 IVF 产生的妊娠。[81]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/fulltexthttp://www.ncbi.nlm.nih.gov/pubmed/23518030?tool=bestpractice.com[82]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[83]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/fulltexthttp://www.ncbi.nlm.nih.gov/pubmed/27336211?tool=bestpractice.com