Efficacy of the Laparoscopic Milking Technique in the Management of Ectopic Pregnancy: Impact on Fertility Prognosis and Persistent Trophoblastic Tissue Laparoskopik Milking Tekniğinin Ektopik Gebelik Yönetimindeki Etkinliği: Fertilite Prognozu ve Persistan Trofoblastik Doku Üzerindeki Etkisi
Turkish Journal of Reproductive Medicine and Surgery, cilt.10, sa.2, ss.62-68, 2026 (Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 10 Sayı: 2
- Basım Tarihi: 2026
- Doi Numarası: 10.24074/tjrms.2026.08208
- Dergi Adı: Turkish Journal of Reproductive Medicine and Surgery
- Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.62-68
- Anahtar Kelimeler: cornual, Fallopian tube, fertility, laparoscopy, pregnancy, salpingostomy
- Lokman Hekim Üniversitesi Adresli: Evet
Özet
Objective: To compare long-term fertility outcomes among patients with tubal ectopic pregnancy managed with different treatment approaches and to evaluate the incidence of persistent trophoblastic tissue following conservative surgical treatment. Material and Methods: This retrospective, single-center study included patients with tubal ectopic pregnancy who desired future fertility and were treated between 2012 and 2022. Management approaches included milking, salpingostomy, salpingectomy, or methotrexate (MTX), selected according to clinical findings. Long-term fertility outcomes were assessed over a ten-year follow-up period and included subsequent pregnancy, live birth, miscarriage, and recurrent ectopic pregnancy. Persistent trophoblastic tissue after conservative surgery was defined as a less than 50% decline in serum beta-human chorionic gonadotropin levels on the first postoperative day. Results: Seventy-one patients were included. During follow-up, 69% achieved pregnancy. No significant differences were observed among treatment groups regarding long-term fertility outcomes, time to conception, or subsequent pregnancy outcomes. The presence of fetal cardiac activity was the only factor significantly associated with future fertility prognosis. Persistent trophoblastic tissue occurred in 28% of patients who underwent conservative surgery, with no significant difference between the milking and salpingostomy groups. Patients with persistent trophoblastic tissue experienced a significantly longer time to conception. Conclusion: Long-term fertility outcomes after milking, salpingostomy, salpingectomy, and MTX treatment for tubal ectopic pregnancy were comparable. Laparoscopic milking appears to be a safe fertility-preserving option in selected patients. Given its potential to delay conception, persistent trophoblastic tissue warrants careful postoperative follow-up after conservative surgery.