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

摘要

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 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.