A series to extrauterine pregnancies treated with conservative laparoscopic techniques was the basis for an evaluation of the subsequent fertility of 223 women. Treatment for extrauterine pregnancy should be based on a proven and reproducible technique that does not expose the patient to a significant risk f complications or failure in the hands of a well trained surgeon. The treatment should preserve the fertility of patients desiring later pregnancy if possible while controlling the risk of recurrence. No operative complications justifying laparotomy were observed in the author's series of 321 cases, and their failure rate of 4.8% was not significantly different from that reported after conservative treatment by laparotomy. Subsequent fertility, explored in terms of intrauterine pregnancy, recurrence of ectopic pregnancy and sterility, or in cumulative intrauterine pregnancy rates, was comparable or superior to that of the principle series treated by laparotomy, whether radical or conservative and using or not using microsurgical techniques. In appears that, in the absence of the few rare contraindications, the most satisfactory surgical treatment of extrauterine pregnancy at present is laparoscopic. The possibility of intrauterine pregnancy should be kept in mind in choosing between radical and conservative laparoscopic treatment. The authors found in their series of 223 patients desiring subsequent pregnancy that factors significantly affecting the fertility prognosis included the presence of adhesions on the tube, the condition of the contralateral tube, and a history of salpingitis. Neither age, parity, nor the characteristics of the extrauterine pregnancy significantly affected the possibility of pregnancy. A treatment score was created based on the results of a multiple regression analysis that assessed the fertility impact of 8 risk factors. A coefficient of 2 was assigned to a history of ectopic pregnancy or tubal microsurgery or to presence of a single tube. A coefficient of 1 was assigned to each additional ectopic pregnancy after the 1st, to a history of laparoscopic adhesiolysis, to homolateral and contralateral adhesions, and to a history of salpingitis. A score of 6 or over indicated that the patient's hopes of subsequent pregnancy would be maximized by radical laparoscopic treatment and sterilization of the contralateral tube to avoid recurrence, and attempts at in vitro fertilization. Patients with a score of 5 had approximately equal chances of recurrence or intrauterine pregnancy after conservative laparoscopic treatment. But radical treatment would greatly reduce chances of recurrence and increase chances of normal pregnancy. Patients with a score of 4 or less had much greater chances of normal pregnancy than of recurrence after conservative laparoscopic treatment. Women desiring pregnancy who failed to conceive within 2 years should be referred for in vitro fertilization.