Wir führen an der Universitätsfrauenklinik Frankfurt seit 1984 Refertilisationen sowie Tubenanastomosen wegen anderer Ursachen unter zusätzlicher Anwendung von Fibrinkleber durch. Über die Zweckmäßigkeit dieses Vorgehens ist ausführlich diskutiert worden, sie soll nicht Gegenstand dieses Beitrags sein.

In den letzten Jahrzehnten ist eine weltweite Zunahme ektoper Schwangerschaften (EUG) zu beobachten. Verschiedene Ursachen werden hierfür verantwortlich gemacht: Optimierung der Diagnostik, Verwendung des IUD, Veränderungen im Sexualverhalten etc..

The world-wide increase in extrauterine pregnancies induced us to grow trophoblastic elements obtained from ectopic locations in tissue cultures in order to determine whether the tubal implantation of the blastocyst could be caused by chromosomal aberrations. In addition, we investigated for what period of time trophoblastic tissue from ectopic sites is capable of producing HCG in culture. This was done in view of an eventual use of this method as a model for the testing of the effect of antitrophoblastic agents in vitro. Finally, the concentration of several tumor markers in the culture medium was measured. The karyotype could be determined in 16 out of 20 tissue specimen subjected to tissue culture; in one case a chromosomal aberration was recognized, two times there was evidence of increased fragility of the chromosomes. The ratio of female to male karyotypes was 10 to 6. HCG was found to be produced for 6 to 9 days in the tissue cultures. The concentration of the tumor markers CEA, CA 19-9, CA 12-5 and CA 15-3 in the culture medium was low as compared to cultures containing additional tubal mucosa. We are concluding that chromosomal aberrations do not seem to play a causal role in the genesis of EUP. The assay of HCG production by trophoblastic cells in tissue cultures could eventually be used for the testing of agents which might ultimately be employed for the non-surgical treatment of certain cases of EUP.