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Objective <p>To systematically review and compare the clinical efficacy and impact on fertility function between laparoscopic surgery and methotrexate treatment for tubal pregnancy.</p> Methods <p>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. </p> Results <p>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,<i> P</i> &lt; 0.001]; and a significantly higher spontaneous pregnancy rate [OR = 2.10, 95% CI 1.28–3.46, <i>P</i> = 0.003]; and a shorter time for serum HCG levels to return to normal [MD = -7.10, 95% CI −&#xa0;7.84–6.36, <i>P</i> &lt; 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, <i>P</i> = 0.33], and no statistically significant difference in recurrent EP rate [OR = 1.09, 95% CI 0.41–2.87, <i>P</i> = 0.87].</p> Conclusion <p>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.</p>

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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

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月11日

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  • Shan Lin,
  • Run Lin,
  • Haier Liu

摘要

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.