Objective: To explore the change trajectory of fertility and life quality in the reproductive-aged patients after tubal surgery due to ectopic pregnancy, and analyze the relationship with fertility anxiety. Methods: A convenient sampling method was used to select 234 reproductive-aged patients with ectopic pregnancy, who were admitted to the First Affiliated Hospital with Nanjing Medical University from January 2022 to June 2024 as the research subjects. All patients were surveyed using The Fertility Quality of Life (FertiQoL) Scale at 1 week(T1), 4 weeks(T2), 8 weeks(T3), 12 weeks(T4), and 16 weeks(T5) after tubal pregnancy surgery. At 16 weeks postoperatively(T5), the level of postoperative fertility anxiety was surveyed using the Chinese version of the Reproductive Concerns After Cancer Scale(RCAC). A latent class growth model was applied to identify the potential categories of trajectories in the fertility and life quality, and analysis of variance was used to explore the differences in the fertility anxiety score among reproductive-aged patients with ectopic pregnancy across different potential categories of fertility and life quality. Results: The FertiQoL scores of reproductive-aged patients with ectopic pregnancy at different time points (T1 to T5) after tubal surgery were 27-53 (39.16±4.26), 28-65 (45.50±6.69), 43-92 (65.53±9.40), 50-90 (70.20±7.82), and 51-97 (74.02±8.81), respectively. The latent category growth model identified 3 types of trajectory types of change in fertility and life quality in reproductive-aged patients after tubal surgery due to ectopic pregnancy, with 33.33% in the low fertility quality of life-steady increase group (A1), 40.60% in the medium fertility quality of life-improvement significant group (A2), and 26.07% in the high fertility quality of life-rapid increase group (A3). In multivariable analyses using the A1 group as the referent, age<35 years (vs. 35-45 years) was significantly associated with increased odds of belonging to the A2 group (OR=2.558). Factors associated with the A1 group included residence in towns (OR=0.256), rural areas (OR=0.185), and having no fertility intention (OR=0.476). Similarly, age<35 years was associated with the A3 group (OR=2.324), while rural residence (OR=0.119) and no fertility intention (OR=0.212) were associated with the A1 group (all P<0.05). The comparison of the 3 latent categories of RCAC scores showed a significant difference(F=2 327.324, P<0.001). Conclusions: It is suggested that those tubal pregnancy patients with low fertility-related quality of life should be focused in clinical practice. Various forms such as internet platforms, public welfare lectures and news media should be used to strengthen the popularization of knowledge on the treatment and nursing of ectopic pregnancy, especially tubal pregnancy, so as to improve the awareness, understanding and tolerance of key groups including patients, their family members and women with fertility needs towards ectopic pregnancy. In addition, psychological counseling for those patients should be strengthened to reduce their fertility anxiety and improve their fertility-related quality of life.