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"Liu, Haier"
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The clinical efficacy and impact on fertility function of laparoscopic surgery versus methotrexate for treatment of tubal pregnancy: a meta-analysis
by
Lin, Shan
,
Lin, Run
,
Liu, Haier
in
Biomaterials
,
Biomedical Engineering and Bioengineering
,
Biomedical Engineering/Biotechnology
2025
Objective
To systematically review and compare the clinical efficacy and impact on fertility function between laparoscopic surgery and methotrexate treatment for tubal pregnancy.
Methods
Five English databases and four Chinese databases were systematically searched from the database establishment to January 31, 2024, and a meta-analysis was conducted using Review Manager 5.3.
Results
Ten articles were included, with a total of 1,034 study patients. The meta-analysis showed that compared with a single intramuscular injection of methotrexate, laparoscopic surgery for tubal pregnancy was associated with a significantly higher tubal patency rate [OR = 2.47, 95% CI 1.72–3.53,
P
< 0.001]; and a significantly higher spontaneous pregnancy rate [OR = 2.10, 95% CI 1.28–3.46,
P
= 0.003]; and a shorter time for serum HCG levels to return to normal [MD = -7.10, 95% CI − 7.84–6.36,
P
< 0.001]. However, there was no statistically significant difference in treatment success rate between the two treatment methods [OR = 1.88, 95% CI 0.53–6.69,
P
= 0.33], and no statistically significant difference in recurrent EP rate [OR = 1.09, 95% CI 0.41–2.87,
P
= 0.87].
Conclusion
Compared with a single intramuscular injection of methotrexate, laparoscopic surgery for tubal pregnancy is associated with better fertility function in the future, while the difference in clinical efficacy needs further exploration.
Journal Article