Does methotrexate administration for ectopic pregnancy after in vitro fertilization impact ovarian reserve or ovarian responsiveness?

Boots, Christina E.; Gustofson, R.L.; Feinberg, Eve C.

doi:10.1016/j.fertnstert.2013.08.007

Cited by 33 publications

(23 citation statements)

References 15 publications

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“…One additional study was excluded because none of the patients were undergoing ART [15]. Seven studies met all the inclusion criteria [16][17][18][19][20][21][22]. As shown in Table 1, five of the studies were retrospective cohort analyses and two were prospective observational studies [19,20].…”

Section: Systematic Reviewmentioning

confidence: 99%

“…The majority of these studies are limited by their retrospective nature and sample size. Only two studies included more than 50 subjects [16,17].…”

Section: Systematic Reviewmentioning

confidence: 99%

“…Three corresponding authors responded, and their patient-level data was utilized [16][17][18]. Complete data was available for 214 subjects (Hill, n = 117; McLaren, n = 23; Boots, n = 66, Washington University, n = 8).…”

Section: Multi-center Retrospective Cohortmentioning

confidence: 99%

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Methotrexate does not affect ovarian reserve or subsequent assisted reproductive technology outcomes

Boots¹,

Hill²,

Feinberg

et al. 2016

J Assist Reprod Genet

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Purpose The purpose of this research was to study whether methotrexate (MTX) as treatment for ectopic pregnancy (EP) impacts the future fertility of women undergoing assisted reproductive technology (ART) Methods In a systematic review and multi-center retrospective cohort from four academic and private fertility centers, 214 women underwent an ART cycle before and after receiving MTX as treatment for an EP. Measures of ovarian reserve and responsiveness and rates of clinical pregnancy (CP) and live birth (LB) were compared in the ART cycles prior and subsequent to MTX. Results Seven studies were identified in the systematic review, and primary data from four institutions was included in the final analysis. Women were significantly older in post-MTX cycles (35.3 vs 34.7 years). There were no differences in follicle stimulating hormone, antral follicle count, duration of stimulation, oocytes retrieved, or fertilization rate between pre-and post-MTX cycles. However, post-MTX cycles received a significantly higher total dose of gonadotropins (4206 vs 3961 IU). Overall, 42 % of women achieved a CP and 35 % achieved a LB in the post-MTX ART cycle, which is similar to national statistics. Although no factors were identified that were predictive of LB in young women, the number of oocytes retrieved in the previous ART cycle and current AFC were predictive of LB (AUC 0.76, 0.75) for the older women. Conclusions MTX does not influence ovarian reserve, response to gonadotropin stimulation, and CP or LB rate after ART. MTX remains a safe and effective treatment option for women with asymptomatic EPs.Capsule As treatment for an ectopic pregnancy, methotrexate does not affect ovarian reserve, response to gonadotropin stimulation, clinical pregnancy, or live birth rates in subsequent assisted reproductive tenchology cycles.

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Section: Systematic Reviewmentioning

confidence: 99%

“…The majority of these studies are limited by their retrospective nature and sample size. Only two studies included more than 50 subjects [16,17].…”

Section: Systematic Reviewmentioning

confidence: 99%

See 1 more Smart Citation

Methotrexate does not affect ovarian reserve or subsequent assisted reproductive technology outcomes

Boots¹,

Hill²,

Feinberg

et al. 2016

J Assist Reprod Genet

Self Cite

View full text Add to dashboard Cite

show abstract

“…Both surgical and medical methods for EP were found to affect ovarian reserve by impairing the proliferation of the germinal cells or blood supply of the ovary [2,4]. However, recently published studies suggested that single-dose MTX in the treatment of EP is safer and may be the first treatment choice [5,6].…”

Section: Introductionmentioning

confidence: 99%

“…Although limited number of studies evaluated the effects of MTX and salpingectomy on the ovarian response [5,15], to the best of our knowledge, there is no study to show and compare the ovarian reserve with AMH and histological follicle count after single or multiple dose MTX exposure and salpingectomy. The aim of this prospective controlled study was to evaluate the effects of single or multiple dose MTX exposure or salpingectomy on the ovarian reserve with AMH and histological assessment in a rat model.…”

Section: Introductionmentioning

confidence: 99%