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  • Title: Fertility following ectopic pregnancy with special reference to previous use of an intra-uterine contraceptive device (IUCD).
    Author: Sandvei R, Ulstein M, Wollen AL.
    Journal: Acta Obstet Gynecol Scand; 1987; 66(2):131-5. PubMed ID: 3618137.
    Abstract:
    A group of 304 women operated on for ectopic pregnancy were followed up with respect to subsequent reproductive performance. The group was distributed into current users, earlier users and non-users of an intra-uterine contraceptive device (IUCD). Pelvic inflammatory disease (PID) and infertility were more common among non IUCD users. Reproductive performance was statistically significantly better in ever-users of an IUCD than in never-users. The proportions of women wishing to become pregnant and who later gave birth to a live baby in the three groups were 69.2%, 61.4% and 38.0% respectively. Pregnancy outcomes of 304 women operated for ectopic pregnancy from 1979-1983 in Bergen Norway were analyzed with regard to prior use of IUDs. It is commonly known that wearing an IUD increases the risk of ectopic pregnancy, and that ectopic pregnancy rates are increasing. The women were classified into those who never used an IUD, those ever using an IUD and those currently using an IUD. The never user group were slightly younger and of lower mean parity. During the study, the percentages of the groups who delivered live babies were 32.5% (69.2% corrected for contraception) among current users, 48.2% (61.14% corrected) among past users and 31% (38%) among never users of IUDs. Combining all pregnancies, miscarriages and legal abortions, the figures were 84.6%, 75% and 42.3%. Thus, fertility after ectopic pregnancy was significantly (p0.0001) better in IUD users than in nonusers. This held for both primigravidae and multigravidae. There was no difference in rates of subsequent ectopic pregnancy. Examining medical records, pelvic inflammatory disease (PID) and infertility were more common in non-IUD users and ex-IUD users. Apparently, the consequences for future fertility or PID were more severe in the group never using an IUD.
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