Medical versus surgical treatment for early pregnancy loss in infertile patients: Which approach facilitates more rapid return to subsequent treatment cycle?

Victoria Vallejo, Hilde I. G. Cotton, Joseph A. Lee, Enrique Cervantes, Benjamin Sandler, Alan B. Copperman

Reproductive Medicine Associates of New York, New York, USA.

DOI: 10.4236/ojog.2012.24074                

Abstract

Patients and physicians confront a challenging dynamic when an early pregnancy loss (EPL) occurs after fertility treatment (FT). Our study focused on the time to resumption of FT in patients managed medically (Cytotec) compared to in those managed surgically with dilatation and curettage (D&C). A retrospective analysis from 2003-2010 of patients receiving treatment for an EPL. Misoprostol (Cytotec) patients were compared with a randomly selected control group (D&C). Both the time from the date of treatment to the date at which βhCG reached <5 mIU/mL and the time until a patient resumed FT was evaluated. We compared the rate of retained product of conception (RPOC) between the 2 groups. Statistical analysis of data was conducted by student-t Test and x². No statistical significance was observed for resumption of FT between groups. Cytotec group had a greater maintenance of retained products of conception versus D&C population (26% vs 2%; p = 0.01). More D&C patients received karyotype results (68% vs 5%). A significant difference was not found in resumption time to the next fertility treatment between the medically and surgical treatment. More medically managed patients RPOC requiring D&C. Although a D&C is more likely to provide karyotype results, medical management is a viable alternative.

Keywords

Misoprostol, Dilatation and Curetta; Fertility Treatment; Cytotec; Retained Products of Conception

Conflicts of Interest

The authors declare no conflicts of interest.

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