If one were to speculate as to which aspects of the diagnosis and management of ectopic pregnancy are most likely to undergo radical change in the next decade, one could reasonably suggest two main areas:

1. Advances in fibreoptics allowing for ever more ingenious and adventurous attempts to cannulate the fallopian tube with a view to non-traumatic diagnosis and gentle treatment.

2. The possibility of successfully re-locating ectopic pregnancy to the uterine cavity. This has been attempted several times in the last century, the earliest recorded attempt being ascribed to Wallace in 1917 who described a successful case following coincidental detection of ectopic pregnancy in a woman undergoing laparotomy for uterine fibroids. More recently, Shettles (1990) described successful reimplantation of a 40-day-old gestational sac using a glass tube pushed through the myometrium until decidua was obtained by gentle suction. A third published case via the cervical route has been contested (Pearce et al., 1994). Numerous other attempts using the transcervical technique have failed (F. Forsdahl, J.G. Westergaard, J.G. Grudzinskas, personal communication). Grudzinskas et al. (1994) have suggested that provided certain prerequisites are fulfilled, such as facilities for accurate and early diagnosis of ectopic pregnancy, counselling for potential recruits, on-call surgical and embryology teams, availability of rapid and accurate karyotyping techniques, and progress in the development of suitable surgical technique for the removal and re-location of the pregnancy, this may be a worthwhile technique to explore.