Laparoscopic conservative treatment of ovarian pregnancy and subsequent Fertility Outcome

Background: Ovarian pregnancy is a rare type of ectopic pregnancy. Laparoscopic surgery is currently the cornerstone of ovarian pregnancy treatment. Few studies have analyzed the clinical outcomes of ovarian pregnancies after laparoscopic treatment, particularly subsequent pregnancies. Objective: The purpose of this study was to assess fertility outcomes subsequent to ovarian pregnancy treated by laparoscopy. Materials and Methods: A retrospective analysis was conducted of women with ovarian pregnancies that were diagnosed and successfully treated by laparoscopy at the E. Wolfson Medical Center during 1997-2009, and these women's subsequent fertility. Results: Eight of 829 women (1%) with ectopic pregnancy were diagnosed as having an ovarian pregnancy. All the patients were admitted either with abdominal pain, amenorrhea, or vaginal bleeding. Two patients (25%) carried an intrauterine device, 2 (25%) had been treated by in vitro fertilization because of male partner and tubal factors, and 1 patient (12.5%) had undergone two previous cesarean deliveries. In all patients, the sonographic results led to incorrect diagnosis of ectopic pregnancy or ruptured ovarian cyst. Additionally, in all patients, a laparoscopic wedge resection of the ovary was performed. Of the 8 patients, 2 did not desire further pregnancy. In another 6 patients, 5 reached term pregnancy and 1 had a miscarriage. Conclusions: Following an ovarian pregnancy treated by laparoscopy, there is a high rate of successful subsequent pregnancy with a good outcome. (J GYNECOL SURG 30:12)