Ectopic Pregnancy After Sterilization

To the Editor.— The article by Glebatis and Janerich,¹ "Ectopic Pregnancies in Upstate New York," and the accompanying editorial by Eschenbach and Daling² suggest that tubal sterilization may increase a woman's risk of ectopic pregnancy and that the increase in tubal sterilization procedures has contributed to the increasing incidence of ectopic pregnancy. Since more than 8% of reproductiveage women in the United States have had a tubal sterilization procedure, such an association would be of important public health concern. Although it is true that a large proportion (5% to 50% ) of pregnancies after tubal sterilization are ectopic gestations, pregnancy after sterilization surgery occurs so infrequently (approximately five per 1,000 women) that it is unlikely that the increase in popularity of tubal sterilization has contributed to the increasing incidence of ectopic pregnancy. Using data from several large studies of contraceptive practices and ectopic pregnancy risk, including a multi-center prospective